Bronchocentric granulomatosis
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 asthmatic patients with 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. The 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
- [Disease name] may be caused by either [cause1], [cause2], or [cause3].
- [Disease name] is caused by a mutation in the [gene1], [gene2], or [gene3] gene[s].
- There are no established causes for [disease name].
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.
- [Disease name] is more commonly observed among patients aged [age range] years old.
- Bronchocentric granulomatosis is more commonly observed among elderly patients.
Gender
- [Disease name] affects men and women equally.
- [Gender 1] are more commonly affected with [disease name] than [gender 2].
- The [gender 1] to [Gender 2] ratio is approximately [number > 1] to 1.
Race
- There is no racial predilection for [disease name].
- [Disease name] usually affects individuals of the [race 1] race.
- [Race 2] individuals are less likely to develop [disease name].
Risk Factors
- Common risk factors in the development of [disease name] are [risk factor 1], [risk factor 2], [risk factor 3], and [risk factor 4].
Natural History, Complications and Prognosis
- The majority of patients with [disease name] remain asymptomatic for [duration/years].
- Early clinical features include [manifestation 1], [manifestation 2], and [manifestation 3].
- If left untreated, [#%] of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
- Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
- Prognosis is generally [excellent/good/poor], and the [1/5/10year mortality/survival rate] of patients with [disease name] is approximately [#%].
Diagnosis
Diagnostic Criteria
- The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met:
- [criterion 1]
- [criterion 2]
- [criterion 3]
- [criterion 4]
Symptoms
- Symptoms of Bronchocentric granulomatosis may include the following:
- Cough
- Wheezing
- Fever
- Dyspnea
- Blood eosinophilia
Physical Examination
- Patients with [disease name] usually appear [general appearance].
- Physical examination may be remarkable for:
- [finding 1]
- [finding 2]
- [finding 3]
- [finding 4]
- [finding 5]
- [finding 6]
Laboratory Findings
- There are no specific laboratory findings associated with [disease name].
- A [positive/negative] [test name] is diagnostic of [disease name].
- An [elevated/reduced] concentration of [serum/blood/urinary/CSF/other] [lab test] is diagnostic of [disease name].
- Other laboratory findings consistent with the diagnosis of [disease name] include [abnormal test 1], [abnormal test 2], and [abnormal test 3].
Imaging Findings
- There are no [imaging study] findings associated with [disease name].
- [Imaging study 1] is the imaging modality of choice for [disease name].
- On [imaging study 1], [disease name] is characterized by [finding 1], [finding 2], and [finding 3].
- [Imaging study 2] may demonstrate [finding 1], [finding 2], and [finding 3].
Other Diagnostic Studies
- [Disease name] may also be diagnosed using [diagnostic study name].
- Findings on [diagnostic study name] include [finding 1], [finding 2], and [finding 3].
Treatment
Medical Therapy
- There is no treatment for [disease name]; the mainstay of therapy is supportive care.
- The mainstay of therapy for [disease name] is [medical therapy 1] and [medical therapy 2].
- [Medical therapy 1] acts by [mechanism of action 1].
- Response to [medical therapy 1] can be monitored with [test/physical finding/imaging] every [frequency/duration].
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 [disease name].
- Effective measures for the primary prevention of [disease name] include [measure1], [measure2], and [measure3].
- Once diagnosed and successfully treated, patients with [disease name] are followed-up every [duration]. Follow-up testing includes [test 1], [test 2], and [test 3].
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.