Follicular bronchiolitis: clinical and pathologic findings in six patients.
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.
Romero
S
S
Servicios de Neumologia, Hospital General Universitario de Alicante, Spain. romero_san@gva.es
Barroso
E
E
Gil
J
J
Aranda
I
I
Alonso
S
S
Garcia-Pachon
E
E
D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000032:analysis; D001706:Biopsy; D001988:Bronchiolitis / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D020566:Dendritic Cells, Follicular / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008168:Lung / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D008214:Lymphocytes / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013030:Spain; D013256:Steroids / Q000627:therapeutic use; D016019:Survival Analysis; D013908:Thoracotomy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D015415:Biomarkers; D013256:Steroids; D011241:Prednisone