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Other interstitial pneumonitis / fibrosis

Respiratory bronchiolitis

Reviewers: Elliot Weisenberg, M.D. (see Reviewers page)
Revised: 25 September 2011, last major update September 2011
Copyright: (c) 2003-2011, PathologyOutlines.com, Inc.


● Common, almost always seen in cigarette smokers generally with 30+ pack year history
● May persist 5 years or more after quitting, often incidental finding (Am J Surg Pathol 2002;26:647)
● May cause cough and dyspnea, usually mild, which regresses after cigarette cessation
● Severe disease known as respiratory bronchiolitis-associated interstitial lung disease

Micro description

● Focal chronic inflammation of terminal bronchioles and alveolar ducts with adjacent focal interstitial inflammation and fibrosis
● Histiocytes fill alveolar ducts and spaces, but are predominantly peribronchiolar
● Histiocyte cytoplasm contains brown-black-yellow granules (smokerís granules)

Differential diagnosis

DIP: no pigmented macrophages

End of Lung-nontumor > Other interstitial pneumonitis / fibrosis > Respiratory bronchiolitis

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