Lung

Other interstitial pneumonitis / fibrosis

Bronchiolocentric interstitial pneumonia



Topic Completed: 1 September 2011

Minor changes: 11 August 2020

Copyright: 2003-2021, PathologyOutlines.com, Inc.

PubMed search: bronchiolocentric interstitial pneumonia

Elliot Weisenberg, M.D.
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Cite this page: Weisenberg E. Bronchiolocentric interstitial pneumonia. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/lungnontumorBIP.html. 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
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