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Difference between revisions of "Constrictive bronchiolitis"
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# | '''Constrictive bronchiolitis''' is rare [[medical lung disease]]. It is also known as '''bronchiolitis obliterans''', '''obliterative broncholitis''',<ref name=pmid16493150/> and '''bronchiolitis obliterans syndrome''' (abbreviated '''BOS''').<ref name=pmid18707652>{{Cite journal | last1 = Sato | first1 = M. | last2 = Keshavjee | first2 = S. | title = Bronchiolitis obliterans syndrome: alloimmune-dependent and -independent injury with aberrant tissue remodeling. | journal = Semin Thorac Cardiovasc Surg | volume = 20 | issue = 2 | pages = 173-82 | month = | year = 2008 | doi = 10.1053/j.semtcvs.2008.05.002 | PMID = 18707652 }}</ref> | ||
It should '''not''' be confused with ''idiopathic [[bronchiolitis obliterans organizing pneumonia]] (BOOP)'', and old term for ''cryptogenic organizing pneumonia''. | |||
==General== | |||
*'''''Not''''' the same as (idiopathic) ''[[bronchiolitis obliterans organizing pneumonia]] (BOOP)'' - in short: | |||
**BOOP: clogs the airway, has Masson bodies, treated with steroids - good prognosis. | |||
**Constrictive bronchiolitis: fibrosis around airways, crappy prognosis. | |||
*No good treatment. | |||
*Progressive. | |||
Etiology/associations:<ref name=pmid16493150/> | |||
*Post-infectious. | |||
**Viral, e.g. [[Adenovirus]]. | |||
**Mycoplasma. | |||
*Post-lung transplant.<ref name=pmid19896545/> | |||
*Post-hematopoietic stem cell transplantation | |||
**Associated with GVHD.<ref name=pmid19896545>{{Cite journal | last1 = Chien | first1 = JW. | last2 = Duncan | first2 = S. | last3 = Williams | first3 = KM. | last4 = Pavletic | first4 = SZ. | title = Bronchiolitis obliterans syndrome after allogeneic hematopoietic stem cell transplantation-an increasingly recognized manifestation of chronic graft-versus-host disease. | journal = Biol Blood Marrow Transplant | volume = 16 | issue = 1 Suppl | pages = S106-14 | month = Jan | year = 2010 | doi = 10.1016/j.bbmt.2009.11.002 | PMID = 19896545 }}</ref> | |||
*Connective tissue disease, mostly [[rheumatoid arthritis]]. | |||
*[[Ulcerative colitis]]. | |||
*Drugs - penicillamine. | |||
*Toxins. | |||
*Idiopathic. | |||
==Radiology== | |||
*Hyperlucent lung (due to air trapping). | |||
==Microscopic== | |||
Features:<ref name=pmid16493150>{{Cite journal | last1 = Visscher | first1 = DW. | last2 = Myers | first2 = JL. | title = Bronchiolitis: the pathologist's perspective. | journal = Proc Am Thorac Soc | volume = 3 | issue = 1 | pages = 41-7 | month = | year = 2006 | doi = 10.1513/pats.200512-124JH | PMID = 16493150 | url = http://pats.atsjournals.org/cgi/content/full/3/1/41 }}</ref> | |||
#Bronchiolitis - mononuclear and neutrophilic. | |||
#*May be minimal late in the disease. | |||
#Fibrosis - submucosal and peribronchiolar. | |||
#*Can be patchy. | |||
Notes: | |||
*Bronchioles = noncartilagenous airways usu. < 2 mm in diameter.<ref name=pmid16493150/> | |||
*May be patchy. | |||
*Diagnosis should be considered if the airway is smaller than the accompanying artery. | |||
===Images=== | |||
*[http://www.atsjournals.org/doi/abs/10.1513/pats.200512-124JH?journalCode=pats#readcube-epdf Constrictive bronchiolitis - Figure 4 (atsjournals.org)].<ref name=pmid16493150>{{Cite journal | last1 = Visscher | first1 = DW. | last2 = Myers | first2 = JL. | title = Bronchiolitis: the pathologist's perspective. | journal = Proc Am Thorac Soc | volume = 3 | issue = 1 | pages = 41-7 | month = | year = 2006 | doi = 10.1513/pats.200512-124JH | PMID = 16493150 | url = http://pats.atsjournals.org/cgi/content/full/3/1/41 }}</ref> | |||
==Stains== | |||
*Elastic trichrome - useful for delineation of obliterated bronchioles. | |||
==See also== | |||
*[[Medical lung diseases]]. | |||
==References== | |||
{{Reflist|1}} | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||
[[Category:Medical lung diseases]] | |||