Definition: Diffuse panbronchiolitis (DPB) is a clinicopathologic entity characterized histologically by chronic inflammation principally affecting the respiratory bronchioles.
Diffuse panbronchiolitis is a progressive interstitial pneumonitis occurring primarily in Japan. Rare cases are now being identified in Europe and North America.
It is manifested clinically by an insidious onset of dyspnea, cough, and production of mucopurulent sputum. Patients often have a history of sinusitis, present with dyspnea on exertion, and show a restrictive pattern on pulmonary function tests.
Synopsis
suppurative bronchiolitis involving primarily the respiratory and terminal bronchioles
- bronchiolectasis
transmural chronic inflammation centered on the terminal bronchioles
interstitial infiltrate of foamy macrophages
centrilobular nodule
- chronic inflammation
- accumulation of foam cells in the walls of the respiratory bronchioles, adjacent alveolar ducts, and alveoli (PB unit lesion)
Differential diagnosis
other chronic airway diseases
cystic fibrosis
bronchiectasis
aspiration pneumonia
extrinsic allergic alveolitis
Wegener granulomatosis
bronchocentric granulomatosis
lymphoma
chronic small airway diseases
References
Iwata M, Colby TV, Kitaichi M. Diffuse panbronchiolitis: diagnosis and distinction from various pulmonary diseases with centrilobular interstitial foam cell accumulations. Hum Pathol. 1994 Apr;25(4):357-63. PMID: 8163268
Randhawa P, Hoagland MH, Yousem SA. Diffuse panbronchiolitis in North America. Report of three cases and review of the literature. Am J Surg Pathol. 1991 Jan;15(1):43-7. PMID: 1985500
Yousem SA. Small airways disease. Pathol Annu. 1991;26 Pt 2:109-43. PMID: 1861883