Jason P Weinman1, David A Manning2, Deborah R Liptzin3, Amanda J Krausert4, Lorna P Browne5. 1. Department of Radiology, Children's Hospital Colorado, 13123 E. 16th Ave., Box 125, Aurora, CO, 80045, USA. jason.weinman@childrenscolorado.org. 2. Department of Radiology, Children's Hospital of New Orleans, New Orleans, LA, USA. 3. Department of Pediatrics, Section of Pediatric Pulmonology, Children's Hospital Colorado, Aurora, CO, USA. 4. New Orleans Forensic Center, New Orleans, LA, USA. 5. Department of Radiology, Children's Hospital Colorado, 13123 E. 16th Ave., Box 125, Aurora, CO, 80045, USA.
Abstract
BACKGROUND: Follicular bronchiolitis is a lymphoproliferative form of interstitial lung disease (ILD) defined by the presence of peribronchial lymphoid follicles. Follicular bronchiolitis has been associated with viral infection, autoimmune disease and immunodeficiency. The most common clinical manifestation is respiratory distress in infancy followed by a prolonged course with gradual improvement. We found no reports of systematic review of high-resolution computed tomography (HRCT) findings in pediatric follicular bronchiolitis. OBJECTIVE: The purpose of this study was to describe the HRCT findings of follicular bronchiolitis in children and correlate these imaging findings with histopathology. MATERIALS AND METHODS: A 5-year retrospective review of all pathology-proven cases of follicular bronchiolitis was performed. Inclusion criteria were age <18 years and an HRCT within 6 months of lung biopsy. HRCTs were reviewed by three observers and scored using the system previously described by Brody et al. RESULTS: Six patients met the inclusion criteria with age range at HRCT of 7-82 months (median: 39.5 months). Pulmonary nodules (n=6) were the most common HRCT finding followed by focal consolidation (n=5), bronchiectasis (n=4) and lymphadenopathy (n=3). Tree and bud opacities and nodules on CT correlated with interstitial lymphocytic infiltrates and discrete lymphoid follicles on pathology. CONCLUSION: The salient HRCT findings of childhood follicular bronchiolitis are bilateral, lower lung zone predominant pulmonary nodules and bronchiectasis with infantile onset of symptoms. These characteristic HRCT findings help differentiate follicular bronchiolitis from other forms of infantile onset ILD.
BACKGROUND:Follicular bronchiolitis is a lymphoproliferative form of interstitial lung disease (ILD) defined by the presence of peribronchial lymphoid follicles. Follicular bronchiolitis has been associated with viral infection, autoimmune disease and immunodeficiency. The most common clinical manifestation is respiratory distress in infancy followed by a prolonged course with gradual improvement. We found no reports of systematic review of high-resolution computed tomography (HRCT) findings in pediatric follicular bronchiolitis. OBJECTIVE: The purpose of this study was to describe the HRCT findings of follicular bronchiolitis in children and correlate these imaging findings with histopathology. MATERIALS AND METHODS: A 5-year retrospective review of all pathology-proven cases of follicular bronchiolitis was performed. Inclusion criteria were age <18 years and an HRCT within 6 months of lung biopsy. HRCTs were reviewed by three observers and scored using the system previously described by Brody et al. RESULTS: Six patients met the inclusion criteria with age range at HRCT of 7-82 months (median: 39.5 months). Pulmonary nodules (n=6) were the most common HRCT finding followed by focal consolidation (n=5), bronchiectasis (n=4) and lymphadenopathy (n=3). Tree and bud opacities and nodules on CT correlated with interstitial lymphocytic infiltrates and discrete lymphoid follicles on pathology. CONCLUSION: The salient HRCT findings of childhood follicular bronchiolitis are bilateral, lower lung zone predominant pulmonary nodules and bronchiectasis with infantile onset of symptoms. These characteristic HRCT findings help differentiate follicular bronchiolitis from other forms of infantile onset ILD.
Authors: Alan S Brody; R Paul Guillerman; Thomas C Hay; Brandie D Wagner; Lisa R Young; Gail H Deutsch; Leland L Fan; Robin R Deterding Journal: AJR Am J Roentgenol Date: 2010-01 Impact factor: 3.959
Authors: Alan S Brody; Heidi Sucharew; Jonathan D Campbell; Steven P Millard; Paul L Molina; Jeffrey S Klein; Joanne Quan Journal: Am J Respir Crit Care Med Date: 2005-08-11 Impact factor: 21.405
Authors: Benjamin D LeMoine; Lorna P Browne; Deborah R Liptzin; Robin R Deterding; Csaba Galambos; Jason P Weinman Journal: Pediatr Radiol Date: 2019-03-30
Authors: Jason P Weinman; Christina J White; Deborah R Liptzin; Robin R Deterding; Csaba Galambos; Lorna P Browne Journal: Pediatr Radiol Date: 2018-04-23