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Thoracic Imaging |
1 From the Departments of Radiology (S.J.H., N.L.M.) and Pathology (J.D.A.F.), Vancouver Hospital and Health Sciences Centre, University of British Columbia, 855 W 12th Ave, Vancouver, BC, Canada V5Z 1M9; the Departments of Radiology (D.M.H.) and Pathology (A.G.N.), Royal Brompton National Heart and Lung Hospital, London, England; and the Department of Respiratory Medicine, Green Lane Hospital, Auckland, New Zealand (A.U.W.). Received September 10, 1998; revision requested November 2; revision received December 14; accepted March 26, 1999. Address reprint requests to N.L.M.
PURPOSE: To evaluate the thin-section computed tomographic (CT) findings of follicular bronchiolitis and compare them with the histologic findings.
MATERIALS AND METHODS: Thin-section CT scans obtained in 12 patients (age range, 24–77 years; mean age, 47 years) with follicular bronchiolitis proved at open lung biopsy were reviewed by two observers. Underlying conditions included rheumatoid arthritis (n = 8), mixed collagen vascular disorders (n = 2), autoimmune disorder (n = 1), and acquired immunodeficiency syndrome (n = 1). All patients had thin-section CT scans (1.0–1.5-mm collimation, 11 patients; 3.0-mm collimation, one patient; high-spatial-frequency reconstruction algorithm) obtained at 10-mm intervals through the chest.
RESULTS: The main CT findings included bilateral centrilobular (n = 12) and peribronchial (n = 5) nodules. All 12 patients had nodules smaller than 3 mm in diameter; six patients also had nodules 3–12 mm in diameter. Areas of ground-glass opacity were present in nine (75%) patients. Histologically, all patients had lymphoid hyperplasia along the bronchioles; eight had peribronchiolar lymphocytic infiltration.
CONCLUSION: The cardinal CT feature of follicular bronchiolitis consists of small centrilobular nodules variably associated with peribronchial nodules and areas of ground-glass opacity.
Index terms: Bronchiolitis, 60.2191 • Lung, CT, 60.12118 • Lung, nodule, 60.281 • Lymphatic system, hyperplasia, 996.826 • Pneumonitis, lymphocytic interstitial, 60.213
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