Elsevier

Human Pathology

Volume 25, Issue 4, April 1994, Pages 357-363
Human Pathology

Original contribution
Diffuse panbronchiolitis: Diagnosis and distinction from various pulmonary diseases with centrilobular interstitial foam cell accumulations

https://doi.org/10.1016/0046-8177(94)90143-0Get rights and content

Abstract

Diffuse panbronchiolitis (DPB) is a clinicopathologic entity characterized histologically by chronic inflammation principally affecting the respiratory bronchioles. Few pathologists outside Japan are familiar with this entity. The most distinctive pathologic feature of DPB is chronic inflammation and an accumulation of foam cells in the walls of the respiratory bronchioles, adjacent alveolar ducts, and alveoli (PB unit lesion). The differential diagnosis is important both clinically and histologically because of the similarity of DPB to other chronic airway diseases. We report seven cases of DPB and 20 examples of a histologically similar lesion (PB-like lesion) found in a large review of cases of bronchiolitis, cystic fibrosis, bronchiectasis, aspiration pneumonia, extrinsic allergic alveolitis, Wegener's granulomatosis, bronchocentric granulomatosis, and malignant lymphoma. The results indicate that the PB-like lesion is a nonspecific histologic finding; the diagnosis of DPB can be made only in the appropriate clinical setting and when other conditions have been carefully ruled out.

References (39)

  • M Kitaichi et al.

    Diffuse panbronchiolitis

  • M Kitaichi
  • V Poletti et al.

    Diffuse panbronchiolitis observed in an Italian male

    Sarcoidosis

    (1992)
  • P Randhawa et al.

    Diffuse panbronchiolitis in North America. Report of three cases and review of the literature

    Am J Surg Pathol

    (1991)
  • S Saito et al.

    A case of allergic granulomatosis angiitis (Churg-Strauss) associated with diffuse panbronchiolitis

    Nippon Naika Gakkai Zasshi

    (1988)
  • A Okano et al.

    A case of diffuse panbronchiolitis complicated by malignant thymoma and Sjögren syndrome

    Nippon Kyobu Shikkan Gakkai Zasshi

    (1991)
  • K Ono et al.

    Diffuse panbronchiolitis as a pulmonary complication in patients with adult T-cell leukemia

    Am J Hematol

    (1989)
  • T Mimura et al.

    Non-Hodgkin's lymphoma associated with diffuse panbronchiolitis

    Nippon Kyobu Shikkan Gakkai Zasshi

    (1987)
  • M Suzuki et al.

    Familial cases of diffuse panbronchiolitis

    Nippon Kyobu Shikkan Gakkai Zasshi

    (1981)
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