HRCT findings of childhood follicular bronchiolitis

Jason P. Weinman, David A. Manning, Deborah R. Liptzin, Amanda J. Krausert, Lorna P. Browne

Research output: Contribution to journalReview articlepeer-review

8 Scopus citations

Abstract

Background: Follicular bronchiolitis is a lymphoproliferative form of interstitial lung disease (ILD) defined by the presence of peribronchial lymphoid follicles. Follicular bronchiolitis has been associated with viral infection, autoimmune disease and immunodeficiency. The most common clinical manifestation is respiratory distress in infancy followed by a prolonged course with gradual improvement. We found no reports of systematic review of high-resolution computed tomography (HRCT) findings in pediatric follicular bronchiolitis. Objective: The purpose of this study was to describe the HRCT findings of follicular bronchiolitis in children and correlate these imaging findings with histopathology. Materials and methods: A 5-year retrospective review of all pathology-proven cases of follicular bronchiolitis was performed. Inclusion criteria were age <18 years and an HRCT within 6 months of lung biopsy. HRCTs were reviewed by three observers and scored using the system previously described by Brody et al. Results: Six patients met the inclusion criteria with age range at HRCT of 7–82 months (median: 39.5 months). Pulmonary nodules (n=6) were the most common HRCT finding followed by focal consolidation (n=5), bronchiectasis (n=4) and lymphadenopathy (n=3). Tree and bud opacities and nodules on CT correlated with interstitial lymphocytic infiltrates and discrete lymphoid follicles on pathology. Conclusion: The salient HRCT findings of childhood follicular bronchiolitis are bilateral, lower lung zone predominant pulmonary nodules and bronchiectasis with infantile onset of symptoms. These characteristic HRCT findings help differentiate follicular bronchiolitis from other forms of infantile onset ILD.

Original languageEnglish
Pages (from-to)1759-1765
Number of pages7
JournalPediatric Radiology
Volume47
Issue number13
DOIs
StatePublished - Dec 1 2017

Keywords

  • Bronchiectasis
  • Chest
  • Children
  • Computed tomography
  • Follicular bronchiolitis
  • Interstitial lung disease
  • Lung
  • Nodule

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