Follicular bronchiolitis: clinical and pathologic findings in six patients

Lung. 2003 Nov-Dec;181(6):309-19. doi: 10.1007/s00408-003-1031-0.

Abstract

The purpose of this study was to review our experience with patients who had a definitive diagnosis of follicular bronchiolitis (FB), and to describe in detail the clinical and pathological findings, looking for common clinical aspects that may help to identify this entity. Ours is a community 750 bed teaching hospital that acts as a tertiary referral center for several subspecialties, including thoracic surgery. Six patients with a morphological diagnosis of FB, defined by the presence of coalescent germinal centers adjacent to airways, were included. Lung biopsy was obtained by thoracotomy in all patients (2 women and 4 men, mean age 53 years). In one patient FB was associated with advanced AIDS, and in another with prolonged exposure to polyethylene-flock. In 4 patients no condition previously associated with FB was found. Five patients had a history of repeated respiratory infections, 3 patients complained of dyspnea and none had peripheral blood eosinophilia. After a mean follow-up of 25 months, 2 patients responded well to steroid therapy; 3 patients suffered symptomatic exacerbations that required an increase in the steroid dose and 1 patient was not treated with steroids. The most important contribution of this series is the description of a subset of patients with FB who were not associated with other processes. These patients present relatively homogeneous clinical and pathological pictures that do not differ greatly from secondary forms.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Anti-Inflammatory Agents / therapeutic use
  • Biomarkers / analysis
  • Biopsy
  • Bronchiolitis / diagnosis*
  • Bronchiolitis / mortality
  • Bronchiolitis / pathology*
  • Bronchiolitis / therapy
  • Dendritic Cells, Follicular / metabolism
  • Female
  • Follow-Up Studies
  • Humans
  • Immunohistochemistry
  • Lung / metabolism
  • Lung / pathology
  • Lung / surgery
  • Lymphocytes / metabolism
  • Male
  • Middle Aged
  • Prednisone / therapeutic use
  • Respiratory Function Tests
  • Retrospective Studies
  • Severity of Illness Index
  • Spain
  • Steroids / therapeutic use
  • Survival Analysis
  • Thoracotomy
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • Anti-Inflammatory Agents
  • Biomarkers
  • Steroids
  • Prednisone