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A 60-year-old man, a heavy smoker, presents for advice to stop smoking. On physical examination, he is thin and has a ruddy complexion. He has a productive cough and a barrel-shaped chest. He sits leaning forward with his lips pursed to facilitate his breathing. A diagnosis of emphysema is made. Which of the following is the most likely histologic finding in the lungs?
A.
Bronchial smooth muscle hypertrophy with proliferation of eosinophils
B.
Diffuse alveolar damage with leakage of protein-rich fluid into alveolar spaces
C.
Dilation of air spaces with destruction of alveolar walls
D.
Hyperplasia of bronchial mucus-secreting submucosal glands
E.
Permanent bronchial dilation caused by chronic infection, with bronchi filled with mucus and neutrophils