Peribronchiolar metaplasia: A common histologic lesion in diffuse lung disease and a rare cause of interstitial lung disease: Clinicopathologic features of 15 cases

Junya Fukuoka, Teri J. Franks, Thomas V. Colby, Kevin R. Flaherty, Jeffrey R. Galvin, Dennis Hayden, Bernadette R. Gochuico, Ella A. Kazerooni, Fernando Martinez, William D. Travis

Research output: Contribution to journalArticle

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Abstract

Peribronchiolar metaplasia (PBM) is a histologic lesion consisting of peribronchiolar metaplasia (PBM) of bronchiolar-type epithelium. Although widely recognized, PBM has received little attention in the pathologic literature and is not known to have clinical significance. We identified 15 cases in which PBM was the only major histologic finding in surgical lung biopsies from patients with interstitial lung disease (PBM-ILD), and we reviewed the clinical, imaging, and pathologic findings. The mean age was 57 years (range, 44-74 years) with 13 females and 2 males. One patient had been a welder with fume and asbestos exposure; another had pigeon exposure. Smoking history was available for 13 patients: three current smokers, one cocaine user, two former smokers, and seven never smokers. Three patients had collagen vascular disease. One had elevated serum antinuclear antibody titers. Pulmonary function data were available for 10 patients: one obstructive, five restrictive, two mixed obstructive and restrictive, and two normal. Computerized tomography in 7 patients showed mosaic attenuation in 3 patients and air trapping in 1 patient; no bronchiectasis, septal lines, or honeycombing were seen in any cases. All 11 patients with available follow-up are alive; 4 of them have experienced symptomatic improvement (follow-up, 0.6-6.9 years; mean, 2.4 years). PBM was found focally in other interstitial lung diseases, which were assessed for this lesion: 59% of usual interstitial pneumonia (17 of 29), 50% of nonspecific interstitial pneumonia (10 of 20), desquamative interstitial pneumonia (3 of 6), hypersensitivity pneumonitis (9 of 18), and 11% of respiratory bronchiolitis (2 of 18). In summary, PBM is a common histologic finding in various interstitial lung disorders. It is rarely the sole major lung biopsy finding in patients presenting with interstitial lung disease (PBM-ILD). Patients are mostly older women, with mild symptoms and CT findings. Survival appears to be favorable.

Original languageEnglish (US)
Pages (from-to)948-954
Number of pages7
JournalAmerican Journal of Surgical Pathology
Volume29
Issue number7
DOIs
StatePublished - Jul 2005

Fingerprint

Interstitial Lung Diseases
Metaplasia
Lung Diseases
Lung
Extrinsic Allergic Alveolitis
Biopsy
Collagen Diseases
Idiopathic Pulmonary Fibrosis
Bronchiolitis
Bronchiectasis
Antinuclear Antibodies
Asbestos
Columbidae
Vascular Diseases
Cocaine
Epithelium
Smoking
History
Air
Tomography

Keywords

  • Bronchiolar fibrosis
  • Bronchiolar metaplasia
  • Bronchiolitis obliterans
  • High resolution computed tomography
  • Interstitial lung disease
  • Pathology
  • Peribronchiolar metaplasia
  • Small airway disease

ASJC Scopus subject areas

  • Anatomy
  • Pathology and Forensic Medicine

Cite this

Peribronchiolar metaplasia : A common histologic lesion in diffuse lung disease and a rare cause of interstitial lung disease: Clinicopathologic features of 15 cases. / Fukuoka, Junya; Franks, Teri J.; Colby, Thomas V.; Flaherty, Kevin R.; Galvin, Jeffrey R.; Hayden, Dennis; Gochuico, Bernadette R.; Kazerooni, Ella A.; Martinez, Fernando; Travis, William D.

In: American Journal of Surgical Pathology, Vol. 29, No. 7, 07.2005, p. 948-954.

Research output: Contribution to journalArticle

Fukuoka, Junya ; Franks, Teri J. ; Colby, Thomas V. ; Flaherty, Kevin R. ; Galvin, Jeffrey R. ; Hayden, Dennis ; Gochuico, Bernadette R. ; Kazerooni, Ella A. ; Martinez, Fernando ; Travis, William D. / Peribronchiolar metaplasia : A common histologic lesion in diffuse lung disease and a rare cause of interstitial lung disease: Clinicopathologic features of 15 cases. In: American Journal of Surgical Pathology. 2005 ; Vol. 29, No. 7. pp. 948-954.
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abstract = "Peribronchiolar metaplasia (PBM) is a histologic lesion consisting of peribronchiolar metaplasia (PBM) of bronchiolar-type epithelium. Although widely recognized, PBM has received little attention in the pathologic literature and is not known to have clinical significance. We identified 15 cases in which PBM was the only major histologic finding in surgical lung biopsies from patients with interstitial lung disease (PBM-ILD), and we reviewed the clinical, imaging, and pathologic findings. The mean age was 57 years (range, 44-74 years) with 13 females and 2 males. One patient had been a welder with fume and asbestos exposure; another had pigeon exposure. Smoking history was available for 13 patients: three current smokers, one cocaine user, two former smokers, and seven never smokers. Three patients had collagen vascular disease. One had elevated serum antinuclear antibody titers. Pulmonary function data were available for 10 patients: one obstructive, five restrictive, two mixed obstructive and restrictive, and two normal. Computerized tomography in 7 patients showed mosaic attenuation in 3 patients and air trapping in 1 patient; no bronchiectasis, septal lines, or honeycombing were seen in any cases. All 11 patients with available follow-up are alive; 4 of them have experienced symptomatic improvement (follow-up, 0.6-6.9 years; mean, 2.4 years). PBM was found focally in other interstitial lung diseases, which were assessed for this lesion: 59{\%} of usual interstitial pneumonia (17 of 29), 50{\%} of nonspecific interstitial pneumonia (10 of 20), desquamative interstitial pneumonia (3 of 6), hypersensitivity pneumonitis (9 of 18), and 11{\%} of respiratory bronchiolitis (2 of 18). In summary, PBM is a common histologic finding in various interstitial lung disorders. It is rarely the sole major lung biopsy finding in patients presenting with interstitial lung disease (PBM-ILD). Patients are mostly older women, with mild symptoms and CT findings. Survival appears to be favorable.",
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AU - Galvin, Jeffrey R.

AU - Hayden, Dennis

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KW - Small airway disease

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