Yousem S A, Colby T V, Gaensler E A
Department of Pathology, Presbyterian University Hospital of Pittsburgh, Pennsylvania.
Mayo Clin Proc. 1989 Nov;64(11):1373-80. doi: 10.1016/s0025-6196(12)65379-8.
Respiratory bronchiolitis is a mild inflammatory reaction commonly noted in asymptomatic cigarette smokers. We reviewed 18 cases of respiratory bronchiolitis-associated interstitial lung disease (RB/ILD), which had been diagnosed on the basis of clinical evaluation and open-lung biopsy. All patients were cigarette smokers. The sex distribution of the patients was approximately equal, and their mean age was 36 years. Chest roentgenograms showed reticular or reticulonodular infiltrates in 72% of the patients. Histologically, inflammation of the respiratory bronchioles, filling of the bronchiolar lumens and surrounding alveoli with finely pigmented macrophages, associated interstitial inflammation, and mild fibrosis were noted. In most patients, respiratory improvement ensued when they stopped smoking. Because of histologic similarities to desquamative interstitial pneumonia (DIP), the 18 cases of RB/ILD were compared with 36 cases of DIP. DIP tended to occur in older persons, caused more severe symptoms, displayed ground glass infiltrates on chest roentgenograms, was characterized by more severe interstitial disease on pulmonary function tests, and was often associated with progressive respiratory disease.
呼吸性细支气管炎是一种常见于无症状吸烟者的轻度炎症反应。我们回顾了18例经临床评估和开胸肺活检确诊的呼吸性细支气管炎相关间质性肺病（RB/ILD）病例。所有患者均为吸烟者。患者的性别分布大致相等，平均年龄为36岁。胸部X线片显示72%的患者有网状或网结节状浸润。组织学上，可见呼吸性细支气管炎症、细支气管腔和周围肺泡内充满色素沉着的巨噬细胞、相关的间质性炎症以及轻度纤维化。大多数患者戒烟后呼吸功能改善。由于在组织学上与脱屑性间质性肺炎（DIP）相似，将18例RB/ILD病例与36例DIP病例进行了比较。DIP倾向于发生在老年人中，引起更严重的症状，胸部X线片显示磨玻璃样浸润，肺功能测试显示间质性疾病更严重，且常与进行性呼吸系统疾病相关。
