A female newborn is likely to show which of the following findings on microscopic examination of lungs affected by neonatal respiratory distress syndrome (NRDS)?

In the case of neonatal respiratory distress syndrome (NRDS), the primary pathological findings on microscopic examination of the lungs include the presence of proteinaceous alveolar debris and atelectasis. NRDS is primarily due to a deficiency of surfactant in the lungs, which results in collapse of the alveoli (atelectasis) and the accumulation of fluid and proteins in the alveolar spaces.

This proteinaceous material, which is often described as a "hyaline membrane," consists of surfactant proteins and lipids that are secreted into the alveoli. When surfactant is inadequate, the alveoli cannot remain inflated, leading to atelectasis. The combination of these factors contributes to the impaired gas exchange seen in affected newborns. The presence of proteinaceous debris in the alveoli is characteristic of NRDS and is a key indicator used in diagnosing this condition.

The other findings mentioned do not align with the typical histological presentation of NRDS. For example, prominent type II pneumocyte hyperplasia would indicate a response to injury rather than the primary pathophysiological process of NRDS. Additionally, cytomegalovirus inclusions and vascular necrosis relate to other conditions, and dense lymphocytic infiltrates and interstitial edema