Difference between revisions of "Constrictive bronchiolitis"

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#redirect [[Medical_lung_diseases#Constrictive_bronchiolitis]]
'''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]]

Latest revision as of 03:17, 22 March 2018

Constrictive bronchiolitis is rare medical lung disease. It is also known as bronchiolitis obliterans, obliterative broncholitis,[1] and bronchiolitis obliterans syndrome (abbreviated BOS).[2]

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:[1]

Radiology

  • Hyperlucent lung (due to air trapping).

Microscopic

Features:[1]

  1. Bronchiolitis - mononuclear and neutrophilic.
    • May be minimal late in the disease.
  2. Fibrosis - submucosal and peribronchiolar.
    • Can be patchy.

Notes:

  • Bronchioles = noncartilagenous airways usu. < 2 mm in diameter.[1]
  • May be patchy.
  • Diagnosis should be considered if the airway is smaller than the accompanying artery.

Images

Stains

  • Elastic trichrome - useful for delineation of obliterated bronchioles.

See also

References

  1. ↑ 1.0 1.1 1.2 1.3 1.4 Visscher, DW.; Myers, JL. (2006). "Bronchiolitis: the pathologist's perspective.". Proc Am Thorac Soc 3 (1): 41-7. doi:10.1513/pats.200512-124JH. PMID 16493150. http://pats.atsjournals.org/cgi/content/full/3/1/41.
  2. ↑ Sato, M.; Keshavjee, S. (2008). "Bronchiolitis obliterans syndrome: alloimmune-dependent and -independent injury with aberrant tissue remodeling.". Semin Thorac Cardiovasc Surg 20 (2): 173-82. doi:10.1053/j.semtcvs.2008.05.002. PMID 18707652.
  3. ↑ 3.0 3.1 Chien, JW.; Duncan, S.; Williams, KM.; Pavletic, SZ. (Jan 2010). "Bronchiolitis obliterans syndrome after allogeneic hematopoietic stem cell transplantation-an increasingly recognized manifestation of chronic graft-versus-host disease.". Biol Blood Marrow Transplant 16 (1 Suppl): S106-14. doi:10.1016/j.bbmt.2009.11.002. PMID 19896545.
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