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Query: EC:6.2.1.7 (
BAL
)
1,977
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
A 66-year-old male presented to our hospital in January 1990 with chief complaints of hemoptysis and cough. These symptoms had developed 10 months previously and had gradually increased. Fine crepitations were audible over the right lower lung field. There were no results suggesting an inflammatory process such as leucocytosis, elevation of ESR or positive CRP reaction. Chest X-ray film on the first visit showed fine nodular shadows in the right lower lung field, and chest CT revealed fine nodular shadows and mild dilatation of the right lower lobe bronchus. Transbronchial lung biopsy specimens showed granulomas with multinucleated giant cells, alveolitis and Masson bodies. The open lung biopsy specimens showed numerous macrophages and foreign body giant cells, and extensive organizing exudates in the bronchioles and alveolar spaces. Proliferation of smooth muscle and fibrosis around the dilated bronchioles were also seen. Thus, this patient demonstrated
BOOP
pattern, with granulomas and foreign body giant cells. His hemoptysis appeared to have resulted from inflammation of dilated bronchioles. His symptoms and abnormal shadows on chest X-ray improved without any therapy after admission. After treatment with corticosteroid, the diffuse fine nodular shadows disappeared. There has been no recurrence of symptoms to date, although this patient has continued living in the same environment as prior to admission.
BAL
findings during his prolonged follow-up revealed decrease in lymphocytes and elevation of CD4/CD8 ratio. Although the presence of granulomas suggests the possibility of an allergic reaction, no antigenic material could be identified in this case.(ABSTRACT TRUNCATED AT 250 WORDS)
...
PMID:[A case of interstitial pneumonitis with hemoptysis, BOOP (bronchiolitis obliterans organizing pneumonia) pattern, granulomas and foreign body giant cells in lung biopsy]. 150 90
Bronchiolitis obliterans organizing pneumonia
(
BOOP
) is a pathologic finding common to various injuries to the lung of either definite or idiopathic etiology. Since the presentation of patients with idiopathic
BOOP
varies, we studied 16 patients with
BOOP
on pulmonary histology to define more distinct and homogeneous clinical and imaging profiles of idiopathic
BOOP
. We distinguished three groups of patients: group 1 (n = 4), with multiple patchy migratory pulmonary involvement of the pneumonia type. Their clinical course was subacute, with cough, fever, weight loss, mild dyspnea, and increased ESR. Chest x-ray film and CT scan showed multiple alveolar opacities. All patients completely recovered with corticosteroid therapy but relapsed when therapy was stopped too rapidly. Group 2 (n = 5) had solitary pulmonary involvement of the pneumonia type occurring in a similar clinical context. Since carcinoma was suspected, they underwent surgical excision of the pneumonic area and recovered without relapse. Group 3 patients (n = 7) presented with diffuse pulmonary involvement of the interstitial lung disease type. They had more progressive onset of more severe dyspnea, crackles heard over all lung surfaces, and interstitial opacities with or without alveolar opacities on chest imaging. Improvement with corticosteroid therapy was obtained in only three patients. In all three groups, lung function test results showed a restrictive pattern. The obstructive pattern characteristic of pure bronchiolitis obliterans was found in none.
BAL
showed a mixed pattern (increase of both lymphocytes and polymorphonuclear cells) in the patients of the first two groups. Thus, we distinguished three characteristic clinical and imaging profiles in patients with idiopathic
BOOP
: multiple patchy pneumonia, solitary pneumonia, and diffuse interstitial lung disease. These profiles are so different that they should be distinguished in clinical studies of idiopathic
BOOP
.
...
PMID:Idiopathic bronchiolitis obliterans organizing pneumonia. Definition of characteristic clinical profiles in a series of 16 patients. 280 73
Inflammation involving the small airways is a quite common report in pathological dissertations. However the radiologic, clinical patterns and functional impairment of adult bronchiolitis have been discussed in detail only in the last ten years. In this review a brief summary of the anatomic and histologic characteristic of small airways is reported. A pathologic classification of bronchiolitis is at first discussed. Cellular bronchiolitis, proliferative bronchiolitis with or without intraalveolar loose fibrosis (
BOOP
pattern), occlusive and constrictive bronchiolitis are the main patterns taken into account: peculiar subtypes (follicular bronchiolitis, diffuse panbronchiolitis, neuroendocrine cell hyperplasia with fibrous bronchiolitis) are included in the pathologic discussion. Radiologic features are reported and presented as nonspecific. HRCT Scan findings are classified with the appropriate pathologic features in: nodules and branching lines; low attenuation and mosaic perfusion; ground glass attenuation and/or alveolar consolidation. The clinical entities considered are: bronchiolitis secondary to irritant inhalation; infectious and post-infectious bronchiolitis; drug induced bronchiolitis; bronchiolitis in patients with collagen-vascular disease; diffuse panbronchiolitis; bronchiolitis in transplanted patients; neuroendocrine cell hyperplasia with fibrous bronchiolitis: cryptogenic bronchiolitis; idiopathic
BOOP
; respiratory bronchiolitis with interstitial lung disease (RB-ILD). Their clinical presentation, functional impairment, pathogenetic mechanisms when deemed clinically useful,
BAL
findings and therapeutical schemes are discussed.
...
PMID:Clinical spectrum of adult chronic bronchiolitis. 1056 Jan 22
Systemic sclerosis (SSc) is an autoimmune disorder with a high mortality rate from pulmonary manifestations, such as interstitial lung disease and pulmonary hypertension, seen at autopsy in 90% and 75% of patients, respectively.
Bronchiolitis obliterans with organizing pneumonia
(
BOOP
) has numerous causes, but it has only been reported in three patients with SSc. We present three cases of biopsy-proven
BOOP
in patients with scleroderma spectrum disease, including diffuse cutaneous SSc, mixed connective tissue disease with SSc features, and limited cutaneous SSc that later evolved to dermatomyositis/SSc overlap.
BOOP
and SSc alveolitis have similar findings on spirometry, radiographs, and
BAL
; the definitive diagnosis of
BOOP
was therefore made by open lung biopsy. Cyclophosphamide is the current treatment of alveolitis associated with SSc, whereas high-dose prednisone is used to treat
BOOP
. As a result of this difference, we emphasize the importance of a thorough investigation of pulmonary disease in SSc patients to exclude
BOOP
and treat appropriately.
...
PMID:Bronchiolitis obliterans with organizing pneumonia associated with scleroderma and scleroderma spectrum diseases. 1704 64
Bronchiolitis obliterans organizing pneumonia
(
BOOP
) is a physiopathologic syndrome associating suggestive clinical and imaging features with histopathologic studies showing buds of connective tissue in the lu- men of the distal pulmonary airspace. The aim of the study is a retrospective review of all patients with
BOOP
diagnosed in the Pulmonology Unit of Coimbra Hospital Centre (CHC) between 2000 and 2005. Eleven cases (6 female and 5 male) with mean age 54.8 years were diagnosed. Ten patients were non-smokers and one was an ex-smoker. The mean duration of symptoms was 62.1 days with the initial symptoms dyspnea (8), cough (7), fever (5) and weight loss (2). Nine patients had been given multiple antibiotics, crackles were heard in 6, fever was detected in 6 and dyspnea in 5. Chest X-ray showed bilateral alveolar opacities in 6, focal consolidation in 3, multiple bilateral nodular opacities in 1 and linear opacities in 1. Lung function, performed in 7 patients, showed a reduction in the diffusion capacity in 5.
BAL
was performed in 8, and all revealed an increase in the percentage of lymphocytes, with low CD4/CD8 in 4. Diagnosis was obtained by pulmonary biopsy performed by TBLB (7), VATS (2) and TTLB (1). Systemic corticosteroids were given in 9 patients. Evolution was favourable in 10 and one patient died. The authors emphasise the time symptoms took to develop, the failure of multiple antibiotics, agreement between symptoms and imaging with those published in the literature, the increased lymphocytes in the
BAL
, the usefulness of TBLB and the good response to corticosteroids.
...
PMID:[Bronchiolitis obliterans organizing pneumonia--experience of a pulmonology ward]. 1763 71