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Query: UMLS:C0006271 (bronchiolitis)
 5,174 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Despite improved surgical techniques and advances in immunosuppressive therapy, posttransplant mortality rates remain significantly high in lung transplant patients. Since 1985, 3 of 6 single lung recipients, 3 of 3 double lung recipients, and 4 of 7 heart-lung recipients have died and undergone autopsy. We reviewed the autopsy findings in these patients to determine the type and frequency of pathologic processes associated with mortality. One or more infectious processes was found in every patient at autopsy. Gram-negative bacterial pneumonia and sepsis, found in 7 and 8 of 10 autopsy cases, respectively, were by far the most frequent contributing factors to mortality. Epstein-Barr virus infection was demonstrated in one patient using polymerase chain reaction amplification. Acute transplant rejection was found in only 2 patients and therefore is a much less common factor in the death of lung transplant recipients. Diffuse alveolar damage occurred in 6 patients and bronchiolitis obliterans occurred in 3 patients. These latter two processes may have different etiologies in different patients.
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PMID:Factors contributing to mortality in lung transplant recipients: an autopsy study. 265 22

Diffuse alveolar damage (DAD) is the histologic correlate of most patients with adult respiratory distress syndrome (ARDS). It is a relatively straight forward diagnosis and the main differential diagnosis clinically is acute pneumonia and histologically is bronchiolitis obliterans and organizing pneumonia (BOOP). The histologic progression of DAD includes 3 phases (exudative, proliferative, and fibrotic) that correlate with the time rather than its specific cause. The factors that govern which patients will do well and which will develop a fulminant course is not known.
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PMID:ARDS and diffuse alveolar damage: a pathologist's perspective. 1676 48

The classification scheme of interstitial lung diseases has undergone numerous revisions. The criteria for distinguishing seven distinct subtypes of idiopathic interstitial pneumonias are now well defined by consensus in the recently published ATS/ERS classification of these lung diseases. In our present review the histological patterns of the different types are described and the differential diagnosis of idiopathic interstitial pneumonias is discussed. Surgical lung biopsy remains the gold standard for the diagnosis of interstitial pneumonias, and sampling from at least 2 sites is recommended. Video-assisted thoracoscopic surgical biopsy is the preferred method for obtaining lung tissue as this procedure offers a similar yield as an open thoracotomy The most common histological subtype of chronic interstitial lung disease is the usual interstitial pneumonia [UIP] which makes up 47-71% of cases. The key histologic features include patchy subpleural and paraseptal distribution of remodeling lung architecture with dense fibrosis, frequent honeycombing, and large fibroblastic foci. Temporal and spatial heterogeneity are the hallmarks. Nonspecific interstitial pneumonia [NSIP] occurs primarily in middle-aged women who have never smoked, with more than 5-years survival rate in 80% of patients. The major feature of NSIP is a uniform interstitial thickening of alveolar septa by a fibrosing or cellular process. The cardinal histological feature in respiratory bronchiolitis and desquamative pneumonia is an excess of intraalveolar histiocytes. In both patterns, there is variable interstitial fibrosis and chronic inflammation, and a strong association with a history of smoking. Organizing pneumonia (idiopathic bronchiolitis obliterans-organizing pneumonia [BOOP]) is not strictly an interstitial process, because the alveoli and bronchioles are filled by intraluminal polyps of fibroblastic tissue and the expansion of the interstitium is mild. Lymphocytic interstitial pneumonia [LIP] is currently viewed as a pattern of diffuse reactive pulmonary hyperplasia associated in most cases with EB virus, immunosuppression, or a connective tissue disorder. Malignant transformation may rarely occur. A dense mixed interstitial lymphoid infiltrate is a typical histological finding. Diffuse alveolar damage [DAD] from unknown causes is termed acute interstitial pneumonia [AIP], and is synonymous with cases of Hamman-Rich disease. Hyaline membranes in the exsudative phase and marked expansion of the interstitium later are present.
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PMID:[Histopathological classification of idiopathic interstitial pneumonias]. 2128 Feb 74