Bronchocentric granulomatosis: Difference between revisions
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==Overview== | ==Overview== | ||
Bronchocentric granulomatosis is not a disease per se but a histopathological finding of the bronchi and bronchioles. It is commonly seen in | Bronchocentric granulomatosis is not a disease per se but a histopathological finding of the bronchi and bronchioles. It is commonly seen in association with asthma and allergic bronchopulmonary aspergillosis, but can also be observed in non-asthmatics with no identifiable etiological agent.<ref name="pmid1092235">{{cite journal| author=Katzenstein AL, Liebow AA, Friedman PJ| title=Bronchocentric granulomatosis, mucoid impaction, and hypersensitivity reactions to fungi. | journal=Am Rev Respir Dis | year= 1975 | volume= 111 | issue= 4 | pages= 497-537 | pmid=1092235 | doi=10.1164/arrd.1975.111.4.497 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1092235 }} </ref> | ||
==Historical Perspective== | ==Historical Perspective== | ||
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==Pathophysiology== | ==Pathophysiology== | ||
*There are two patterns observed in Bronchocentric granulomatosis, the more common pattern is observed in young men with asthma | *There are two patterns observed in Bronchocentric granulomatosis, the more common pattern is observed in young men with asthma and less common pattern is seen in older patients who are non-asthmatic. The <ref name="pmid1092235">{{cite journal| author=Katzenstein AL, Liebow AA, Friedman PJ| title=Bronchocentric granulomatosis, mucoid impaction, and hypersensitivity reactions to fungi. | journal=Am Rev Respir Dis | year= 1975 | volume= 111 | issue= 4 | pages= 497-537 | pmid=1092235 | doi=10.1164/arrd.1975.111.4.497 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1092235 }} </ref> | ||
*On microscopic histopathological analysis, there is central necrotizing granulomatous inflammation of the bronchi and bronchioles.<ref name="pmid1092235">{{cite journal| author=Katzenstein AL, Liebow AA, Friedman PJ| title=Bronchocentric granulomatosis, mucoid impaction, and hypersensitivity reactions to fungi. | journal=Am Rev Respir Dis | year= 1975 | volume= 111 | issue= 4 | pages= 497-537 | pmid=1092235 | doi=10.1164/arrd.1975.111.4.497 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1092235 }} </ref> | *On microscopic histopathological analysis, there is central necrotizing granulomatous inflammation of the bronchi and bronchioles.<ref name="pmid1092235">{{cite journal| author=Katzenstein AL, Liebow AA, Friedman PJ| title=Bronchocentric granulomatosis, mucoid impaction, and hypersensitivity reactions to fungi. | journal=Am Rev Respir Dis | year= 1975 | volume= 111 | issue= 4 | pages= 497-537 | pmid=1092235 | doi=10.1164/arrd.1975.111.4.497 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1092235 }} </ref> | ||
==Causes== | ==Causes== | ||
* | * Bronchocentric granulomatosis can be idiopathic or caused by other diseases including asthma and allergic bronchopulmonary aspergillosis. <ref name="pmid7275101">{{cite journal| author=Koss MN, Robinson RG, Hochholzer L| title=Bronchocentric granulomatosis. | journal=Hum Pathol | year= 1981 | volume= 12 | issue= 7 | pages= 632-8 | pmid=7275101 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7275101 }} </ref> | ||
==Differentiating [disease name] from other Diseases== | ==Differentiating [disease name] from other Diseases== | ||
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===Age=== | ===Age=== | ||
*Patients of all age groups may develop Bronchocentric granulomatosis. | *Patients of all age groups may develop Bronchocentric granulomatosis. | ||
===Gender=== | ===Gender=== | ||
* | *Bronchocentric granulomatosis affects men and women equally. | ||
===Race=== | ===Race=== | ||
*There is no racial predilection for | *There is no racial predilection for Bronchocentric granulomatosis. | ||
==Risk Factors== | ==Risk Factors== | ||
*Common risk factors in the development of | *Common risk factors in the development of Bronchocentric granulomatosis are [risk factor 1], [risk factor 2], [risk factor 3], and [risk factor 4]. | ||
== Diagnosis == | == Diagnosis == | ||
===Diagnostic Criteria=== | ===Diagnostic Criteria=== | ||
=== Symptoms === | === Symptoms === | ||
| Line 76: | Line 54: | ||
=== Physical Examination === | === Physical Examination === | ||
=== Laboratory Findings === | === Laboratory Findings === | ||
*There are no specific laboratory findings associated with | *There are no specific laboratory findings associated with Bronchocentric granulomatosis. | ||
*Other laboratory findings consistent with the diagnosis of [disease name] include [abnormal test 1], [abnormal test 2], and [abnormal test 3]. | *Other laboratory findings consistent with the diagnosis of [disease name] include [abnormal test 1], [abnormal test 2], and [abnormal test 3]. | ||
===Imaging Findings=== | ===Imaging Findings=== | ||
*CT is the imaging modality of choice for Bronchocentric granulomatosis. | |||
*On CT, Bronchocentric granulomatosis is characterized by focal mass or lobar consolidation with atelectasis.<ref name="pmid10767190">{{cite journal| author=Ward S, Heyneman LE, Flint JD, Leung AN, Kazerooni EA, Müller NL| title=Bronchocentric granulomatosis: computed tomographic findings in five patients. | journal=Clin Radiol | year= 2000 | volume= 55 | issue= 4 | pages= 296-300 | pmid=10767190 | doi=10.1053/crad.1999.0380 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10767190 }} </ref> | |||
=== Other Diagnostic Studies === | === Other Diagnostic Studies === | ||
* | *Bronchocentric granulomatosis may also be diagnosed using open lung biopsy. | ||
*Findings on | *Findings on open lung biopsy include [finding 1], [finding 2], and [finding 3]. | ||
== Treatment == | == Treatment == | ||
=== Medical Therapy === | === Medical Therapy === | ||
* | *The mainstay of therapy for Bronchocentric granulomatosis is corticosteroids. An anti fungal agent should be given if there is an underlying fungal infection.<ref name="pmid7275101">{{cite journal| author=Koss MN, Robinson RG, Hochholzer L| title=Bronchocentric granulomatosis. | journal=Hum Pathol | year= 1981 | volume= 12 | issue= 7 | pages= 632-8 | pmid=7275101 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7275101 }} </ref><ref name="pmid6852779">{{cite journal| author=Jelihovsky T| title=The structure of bronchial plugs in mucoid impaction, bronchocentric granulomatosis and asthma. | journal=Histopathology | year= 1983 | volume= 7 | issue= 2 | pages= 153-67 | pmid=6852779 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6852779 }} </ref> | ||
=== Surgery === | === Surgery === | ||
| Line 117: | Line 80: | ||
=== Prevention === | === Prevention === | ||
*There are no primary preventive measures available for | *There are no primary preventive measures available for Bronchocentric granulomatoiss. | ||
==References== | ==References== | ||
Revision as of 17:17, 28 December 2018
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Nikhila Palle, M.B.B.S
Overview
Bronchocentric granulomatosis is not a disease per se but a histopathological finding of the bronchi and bronchioles. It is commonly seen in association with asthma and allergic bronchopulmonary aspergillosis, but can also be observed in non-asthmatics with no identifiable etiological agent.[1]
Historical Perspective
- Bronchocentric granulomatosis was first discovered by Liebow, in 1973.[2]
Classification
Pathophysiology
- There are two patterns observed in Bronchocentric granulomatosis, the more common pattern is observed in young men with asthma and less common pattern is seen in older patients who are non-asthmatic. The [1]
- On microscopic histopathological analysis, there is central necrotizing granulomatous inflammation of the bronchi and bronchioles.[1]
Causes
- Bronchocentric granulomatosis can be idiopathic or caused by other diseases including asthma and allergic bronchopulmonary aspergillosis. [3]
Differentiating [disease name] from other Diseases
- Bronchocentric granulomatosis must be differentiated from other diseases that cause fever, cough and chest pain, such as:
- Tuberculosis
- [Differential dx2]
- [Differential dx3]
Epidemiology and Demographics
- The incidence and prevalence of Bronchocentric granulomatosis is not known.
Age
- Patients of all age groups may develop Bronchocentric granulomatosis.
Gender
- Bronchocentric granulomatosis affects men and women equally.
Race
- There is no racial predilection for Bronchocentric granulomatosis.
Risk Factors
- Common risk factors in the development of Bronchocentric granulomatosis are [risk factor 1], [risk factor 2], [risk factor 3], and [risk factor 4].
Diagnosis
Diagnostic Criteria
Symptoms
- Symptoms of Bronchocentric granulomatosis may include the following:
- Cough
- Wheezing
- Fever
- Dyspnea
- Blood eosinophilia
Physical Examination
Laboratory Findings
- There are no specific laboratory findings associated with Bronchocentric granulomatosis.
- Other laboratory findings consistent with the diagnosis of [disease name] include [abnormal test 1], [abnormal test 2], and [abnormal test 3].
Imaging Findings
- CT is the imaging modality of choice for Bronchocentric granulomatosis.
- On CT, Bronchocentric granulomatosis is characterized by focal mass or lobar consolidation with atelectasis.[4]
Other Diagnostic Studies
- Bronchocentric granulomatosis may also be diagnosed using open lung biopsy.
- Findings on open lung biopsy include [finding 1], [finding 2], and [finding 3].
Treatment
Medical Therapy
- The mainstay of therapy for Bronchocentric granulomatosis is corticosteroids. An anti fungal agent should be given if there is an underlying fungal infection.[3][5]
Surgery
- Surgery is the mainstay of therapy for [disease name].
- [Surgical procedure] in conjunction with [chemotherapy/radiation] is the most common approach to the treatment of [disease name].
- [Surgical procedure] can only be performed for patients with [disease stage] [disease name].
Prevention
- There are no primary preventive measures available for Bronchocentric granulomatoiss.
References
- ↑ 1.0 1.1 1.2 Katzenstein AL, Liebow AA, Friedman PJ (1975). "Bronchocentric granulomatosis, mucoid impaction, and hypersensitivity reactions to fungi". Am Rev Respir Dis. 111 (4): 497–537. doi:10.1164/arrd.1975.111.4.497. PMID 1092235.
- ↑ Liebow AA (1973). "The J. Burns Amberson lecture--pulmonary angiitis and granulomatosis". Am Rev Respir Dis. 108 (1): 1–18. doi:10.1164/arrd.1973.108.1.1. PMID 4577269.
- ↑ 3.0 3.1 Koss MN, Robinson RG, Hochholzer L (1981). "Bronchocentric granulomatosis". Hum Pathol. 12 (7): 632–8. PMID 7275101.
- ↑ Ward S, Heyneman LE, Flint JD, Leung AN, Kazerooni EA, Müller NL (2000). "Bronchocentric granulomatosis: computed tomographic findings in five patients". Clin Radiol. 55 (4): 296–300. doi:10.1053/crad.1999.0380. PMID 10767190.
- ↑ Jelihovsky T (1983). "The structure of bronchial plugs in mucoid impaction, bronchocentric granulomatosis and asthma". Histopathology. 7 (2): 153–67. PMID 6852779.