Diffuse panbronchiolitis in a patient with common variable immunodeficiency: a casual association or a pathogenetic correlation?
Diffuse panbronchiolitis (DPB) is an idiopathic inflammatory disease that seems to have an immunological pathogenesis and that causes a severe progressive suppurative and obstructive respiratory disorder. Common variable immunodeficiency (CVID) is the most common serious primary immunodeficiency and it is often associated with respiratory diseases. Herein, we describe a case of DPB in a 41-year-old man affected by CVID. We examined the patient's lungs, focusing on the characteristics of the inflammatory cells and of the foamy macrophagic nodules typical of DPB. Immunohistochemical typing of the lymphocytic infiltrate showed that B-cells were almost absent, matching the immunological profile of CVID. The case described is the first case reported in the literature of DPB in a patient affected by CVID. Moreover it seems to confirm the correlation between an immunodeficiency status and the development of DPB and provides more information on the accumulation of nodules of foamy macrophages in DPB.
The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/5310709471138338.
Department of Medical Biotechnologies, Pathology Unit, University of Siena, strada delle Scotte 6, Siena 53100, Italy. ginori@student.unisi.it.
Alessandro
A
Ginori
Aurora
A
Barone
David
D
Bennett
Marie Aimée Gloria Munezero
MA
Butorano
Maria Grazia
MG
Mastrogiulio
Antonella
A
Fossi
Paola
P
Rottoli
Donatella
D
Spina
D000328:Adult; D001402:B-Lymphocytes / Q000276:immunology; D001988:Bronchiolitis / Q000150:complications* / Q000276:immunology / Q000473:pathology*; D017074:Common Variable Immunodeficiency / Q000150:complications* / Q000276:immunology / Q000473:pathology*; D006192:Haemophilus Infections / Q000150:complications* / Q000276:immunology / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D008297:Male