[Follicular bronchiolitis].
BACKGROUND
Follicular bronchiolitis (FB) is a rare type of cellular bronchiolitis characterised by the presence of hyperplastic lymphoid follicles with reactive germinal centres, distributed along the bronchovascular bundles.


METHODS
A non-smoking 36 year old woman was seen because of progressive exertional dyspnoea for 2 years. Chest x-ray and lung CT scan were normal. Pulmonary function tests revealed irreversible airflow obstruction. Exercise testing showed a ventilatory limitation of aerobic capacity with limitation of volume recruitment. The diagnosis of FB was obtained by surgical biopsy. A deficiency of immunoglobulins G4 and M was found.


CONCLUSIONS
The main clinical manifestation of FB is exertional dyspnoea in a young patient. The lung CT scan frequently shows peripheral micronodules but a normal scan does not exclude the diagnosis. The main causes of FB are collagen vascular diseases (especially rheumatoid arthritis) and immunodeficiency syndromes. The treatment of FB is not well defined.
Perotin
J M
JM
Service de Pneumologie, Hôpital Maison Blanche, CHU de Reims, France.
Deslee
G
G
Dury
S
S
Patey
M
M
Toubas
O
O
Lebargy
F
F
D000328:Adult; D001706:Biopsy; D001988:Bronchiolitis / Q000175:diagnosis*; D004417:Dyspnea / Q000209:etiology; D005260:Female; D006801:Humans; D017099:IgG Deficiency / Q000175:diagnosis; D007075:Immunoglobulin M / Q000172:deficiency; D008168:Lung / Q000473:pathology
D007075:Immunoglobulin M