Constrictive bronchiolitis
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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]
- Post-infectious.
- Viral, e.g. Adenovirus.
- Mycoplasma.
- Post-lung transplant.[3]
- Post-hematopoietic stem cell transplantation
- Associated with GVHD.[3]
- Connective tissue disease, mostly rheumatoid arthritis.
- Ulcerative colitis.
- Drugs - penicillamine.
- Toxins.
- Idiopathic.
Radiology
- Hyperlucent lung (due to air trapping).
Microscopic
Features:[1]
- 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.[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
- ↑ 1.0 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.
- ↑ 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.
- ↑ 3.0 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.