What is a prominent finding in the bronchial epithelium of cystic fibrosis patients?

In patients with cystic fibrosis, a hallmark finding in the bronchial epithelium is hyperplastic glands. This condition is due to the obstructive nature of thick, viscous secretions that accumulate in the airways, leading to an overproduction of mucus. The glands become enlarged or hyperplastic in response to chronic irritation and inflammation caused by mucus stasis and subsequent infections. This hyperplasia is a direct consequence of the malfunctioning cystic fibrosis transmembrane conductance regulator (CFTR) protein, which impairs chloride and bicarbonate ion transport, thus leading to thickening of secretions.

The presence of ciliated cells would typically be normal in healthy bronchial epithelium, thus not distinguishing cystic fibrosis. Squamous metaplasia can occur as a secondary response to injury or chronic inflammation but is not a primary finding characteristic to cystic fibrosis. Atrophy of the epithelium would imply a reduction in epithelial cell numbers or thickness, which is not a prominent feature in cystic fibrosis where the opposite condition (hyperplasia) is observed. Therefore, hyperplastic glands serve as a significant indicator of the pathological changes that occur within the bronchial epithelium in cystic fibrosis patients.