title: [Bronchiolitis obliterans in adults].
abstract: Bronchiols are defined as small upper airways with a diameter less than 2 mm. Two zones are described, membranous bronchioli with a continuous wall and respiratory bronchioli with a discontinuous wall. On the basis of pathology examinations, three disease processes can be recognized. In the first category, the initial inflammatory reaction in chronic obstructive bronchitis may spread to the bronchioli as can immune or infectious diseases resulting in bronchiolitis obliterans. Lesions originating conjointly in the bronchioli and alveoles form a second group including bronchiolitis obliterans organizing pneumoniae, the BOOP syndrome recently described. Histologically these disease entities show characteristic desquamation of the alveolar endothelium and a fibrinoid exudate. Hypoxaemia due to respiratory failure develops progressively and usually responds to corticosteroid therapy. In a third group, the disease is limited to the bronchioli alone with no large airway involvement. Chronic obstructive disease of the small airways has been described in smokers and people exposed to mineral dust. The clinical course often runs to classical chronic obstructive bronchopneumonia. Bronchiolitis obliterans itself, or constrictive bronchiolitis, is differentiated from BOOP due to the proliferative aspect within the lumen. No aetiological agent has been identified. The term bronchiolitis obliterans covers a wide range of more or less well identified entities which unfortunately have the common feature of generally poor response to treatment.
authors.affiliation: Service de Pneumologie, Centre Hospitalier Lyon Sud, Pierre-Bénite.
authors.forename: M
authors.initials: M
authors.lastname: Perrin-Fayolle
mesh_terms: D000328:Adult; D001980:Bronchi / Q000473:pathology; D001989:Bronchiolitis Obliterans / Q000145:classification / Q000175:diagnosis / Q000473:pathology; D003937:Diagnosis, Differential; D006801:Humans; D011379:Prognosis; D011650:Pulmonary Alveoli / Q000473:pathology
vernacular_title: Bronchiolite oblitérante de l'adulte.