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Respiratory bronchiolitis

Field	Value
synonyms	RB-ILD
image	Histopathology of a smoker's macrophage.jpg
caption	A "smoker's macrophage", with yellow to light brown and finely granular cytoplasmic pigment.
width	150px
field	pulmonology

Respiratory bronchiolitis is a lung disease associated with tobacco smoking. In pathology, it is defined by the presence of "smoker's macrophages". When manifesting significant clinical symptoms it is referred to as respiratory bronchiolitis interstitial lung disease (RB-ILD).

Diagnosis

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Diagnosis of respiratory bronchiolitis requires a correlation of clinical, radiologic and pathologic findings:

Clinical: Symptoms and pulmonary function testing
Radiologic: Chest radiograph and high-resolution computed tomography
Pathologic: Lung biopsy with "smoker's macrophages" limited to distal airspaces and peribronchiolar airspaces, and minimal to absent peribronchiolar interstitial fibrotic thickening

Respiratory bronchiolitis interstitial lung disease

Respiratory bronchiolitis interstitial lung disease is respiratory bronchiolitis that manifests as a clinically significant interstitial lung disease.

It is a histological finding, not a pathological description. When associated with disease, it is known as "Respiratory bronchiolitis-associated interstitial lung disease" or "RB-ILD". Also, this disease is predominantly found in the upper lobe with centrilobar ground glass nodules. Importantly, no fibrosis is involved, just bronchial wall thickening. Treatment is to stop smoking.

The appearance is similar to desquamative interstitial pneumonia, and some have suggested that the two conditions are caused by the same processes.

References

William Perry, M.D., M.P.H., Kristine Konopka, M.D.. "Respiratory bronchiolitis".
The accumulation of macrophages is driven by cigarette-smoke-induced oxidative stress, which promotes macrophage recruitment and activation in distal airways.Niewoehner, D. E., Kleinerman, J., & Rice, D. B. (1974). Pathologic changes in the peripheral airways of young cigarette smokers. The New England journal of medicine, 291(15), 755–758. https://doi.org/10.1056/NEJM197410102911503
(2019). "Diffuse smoking-related lung diseases: insights from a radiologic-pathologic correlation". Insights into Imaging.
(2005). "Robbins and Cotran pathologic basis of disease". Elsevier Saunders.
(December 1999). "Respiratory bronchiolitis, respiratory bronchiolitis-associated interstitial lung disease, and desquamative interstitial pneumonia: different entities or part of the spectrum of the same disease process?". AJR Am J Roentgenol.

Info: Wikipedia Source

This article was imported from Wikipedia and is available under the Creative Commons Attribution-ShareAlike 4.0 License. Content has been adapted to SurfDoc format. Original contributors can be found on the article history page.

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