Respiratory bronchiolitis is a lung disease associated with tobacco smoking.[1] In pathology, it is defined by the presence of "smoker's macrophages".[1] When manifesting significant clinical symptoms it is referred to as respiratory bronchiolitis interstitial lung disease (RB-ILD).[1]
Diagnosis
Histopathology of respiratory bronchiolitis: Smoker's macrophages (arrow); mild interstitial lymphocytic infiltrate and mild fibrosis (arrowhead)[2]
Diagnosis of respiratory bronchiolitis requires a correlation of clinical, radiologic and pathologic findings:[1]
Pathologic: Lung biopsy with "smoker's macrophages" limited to distal airspaces and peribronchiolar airspaces, and minimal to absent peribronchiolar interstitial fibrotic thickening
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".[4] 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.
^Cotran, Ramzi S.; Kumar, Vinay; Fausto, Nelson; Nelso Fausto; Robbins, Stanley L.; Abbas, Abul K. (2005). Robbins and Cotran pathologic basis of disease. St. Louis, Mo: Elsevier Saunders. p. 741. ISBN0-7216-0187-1.
