Other interstitial pneumonitis / fibrosis

Bronchiolocentric interstitial pneumonia

Topic Completed: 1 September 2011

Minor changes: 11 August 2020

Copyright: 2003-2021,, Inc.

PubMed search: bronchiolocentric interstitial pneumonia

Elliot Weisenberg, M.D.
Page views in 2020: 696
Page views in 2021 to date: 566
Cite this page: Weisenberg E. Bronchiolocentric interstitial pneumonia. website. Accessed October 25th, 2021.
Definition / general
  • Unclear if distinct entity
  • Uncommon disease resembling hypersensitivity pneumonitis, however, much more aggressive course
  • 80% women, ages 40 - 50 years
  • Xray: interstitial and restrictive lung disease
  • Poor prognosis - 33% dead after mean of 4 years (Mod Pathol 2002;15:1148)
  • Similar pattern seen with rheumatoid arthritis, Sjögren's syndrome, scleroderma, methotrexate and amiodarone (5% - 10% of patients)
Microscopic (histologic) description
  • Centrilobular inflammation with peribronchiolar fibrosis and inflammation radiating into interstitium of distal acinus in a patchy fashion
  • Inflammatory process begins at bronchovascular bundle, accompanied by centrilobular fibrosis and metaplasia
  • Periphery of lobule shows relative sparing
  • No granulomas, no honeycomb change
Differential diagnosis
  • Hypersensitivity pneumonitis: specific cause usually identifiable, less centrilobular fibrosis, usually has granulomas
  • Nonspecific interstitial pneumonia: by definition, excludes bronchiolocentric interstitial injury
Back to top
Image 01 Image 02