Aerni Michelle R, Vassallo Robert, Myers Jeffrey L, Lindell Rebecca M, Ryu Jay H
Division of Pulmonary and Critical Care Medicine, Desk East 18, Mayo Clinic, 200 1st St. SW, Rochester, MN, USA.
Respir Med. 2008 Feb;102(2):307-12. doi: 10.1016/j.rmed.2007.07.032. Epub 2007 Nov 7.
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.
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.
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.
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.
滤泡性细支气管炎是一种在多种临床情况下出现的组织病理学表现。本研究旨在描述其临床放射学特征，并评估与滤泡性细支气管炎相关的预后情况。
在1996年至2005年的9年期间，共观察了12例经肺活检确诊为滤泡性细支气管炎的患者。记录了他们的病历、活检及影像学检查结果，以及最后一次随访时的预后详情。
研究人群包括4名男性和8名女性；诊断时的中位年龄为54岁（范围33 - 81岁）。4例患者有潜在的全身性疾病，包括：2例普通可变免疫缺陷、1例干燥综合征和1例未分化结缔组织病。所有病例均通过外科肺活检确诊。9例患者中滤泡性细支气管炎为主要组织学类型；1例患者同时伴有机化性肺炎、非特异性间质性肺炎和寻常型间质性肺炎，滤泡性细支气管炎为相关的次要组织病理学成分。计算机断层扫描结果包括网状阴影、小结节和磨玻璃影。临床病程的特点是相对稳定，对免疫抑制剂部分有效。在中位随访期47个月期间，在有预后信息的9例患者中，仅1例死亡，且与肺部疾病无关。
滤泡性细支气管炎的组织学病变可能是间质性肺炎的主要表现或相对次要的特征。大多数滤泡性细支气管炎患者的临床病程和预后相对良好，进行性肺部疾病并不常见。
