Elsevier

Respiratory Medicine

Volume 102, Issue 2, February 2008, Pages 307-312
Respiratory Medicine

Follicular bronchiolitis in surgical lung biopsies: Clinical implications in 12 patients

https://doi.org/10.1016/j.rmed.2007.07.032Get rights and content
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Summary

Background

Follicular bronchiolitis is a histopathologic finding that occurs in diverse clinical contexts. The current study was conducted to characterize clinico-radiologic features, and assess outcomes associated with follicular bronchiolitis.

Subjects and methods

Twelve subjects with follicular bronchiolitis on lung biopsy were seen over a 9-year period, between 1996 and 2005. Medical records, biopsy and radiographic findings, and details of outcome at the time of last follow-up were recorded.

Results

The study population included 4 men and 8 women; the median age at diagnosis was 54 years (range, 33–81 years). Four patients had underlying systemic diseases that included: 2 with common variable immunodeficiency, 1 Sjögren's syndrome and 1 undifferentiated connective tissue disease. The diagnosis was obtained by surgical lung biopsy in all cases. Follicular bronchiolitis was the major histologic pattern in 9 patients; organizing pneumonia, nonspecific interstitial pneumonia and usual interstitial pneumonia was seen in 1 patient each with follicular bronchiolitis being an associated secondary histopathologic component. Computed tomographic findings included reticular opacities, small nodules and ground-glass opacities. Clinical course was characterized by relative stability with partial response to immunosuppressive agents. During a median follow-up period of 47 months, only one death occurred—out of 9 patients where the outcome information was available—and was unrelated to lung disease.

Conclusions

The histologic lesion of follicular bronchiolitis may be seen as the predominant finding or a relatively minor feature in interstitial pneumonias. The clinical course and prognosis for most patients with follicular bronchiolitis is relatively good, and progressive lung disease is uncommon.

Abbreviations

AIDS
acquired immunodeficiency syndrome
CT
computed tomography
CTD
connective tissue disease
CVID
common variable immunodeficiency
DIP
desquamative interstitial pneumonia
FB
follicular bronchiolitis
NSIP
nonspecific interstitial pneumonia

Keywords

Bronchiolitis
Biopsy lung
Interstitial lung disease
CT scan pulmonary
Lymphocyte

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