Diffuse aspiration bronchiolitis: analysis of 20 consecutive patients

Hu, Xiaowen; Yi, Eunhee S.; Ryu, Jay H.

doi:10.1590/s1806-37132015000004516

Cited by 21 publications

(22 citation statements)

References 21 publications

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“…Diffuse aspiration bronchiolitis (DAB), once thought to be a disease of the bed-ridden elderly with neurologic disorders predisposing to aspiration, is now recognized in young individuals with and without occult gastroesophageal reflux disease. [46][47][48] Typical histopathologic findings include a foreign body reaction with mural inflammation associated with bronchioles. 39 In cats, a presentation with CT evidence of a tree-in-bud pattern, using clinicopathologic data (including of an underlying condition predisposing to chronic aspiration)…”

Section: Other Primary Bronchiolar Variantsmentioning

confidence: 99%

Perspectives in veterinary medicine: Description and classification of bronchiolar disorders in cats

Reinero

Masseau

Grobman

et al. 2019

Veterinary Internal Medicne

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This Perspectives in Veterinary Medicine article seeks to define, describe putative causes, and discuss key diagnostic tests for primary and secondary bronchiolar disorders to propose a classification scheme in cats with support from a literature review and case examples. The small airways (bronchioles with inner diameters <2 mm), located at the transitional zone between larger conducting airways and the pulmonary acinus, have been overlooked as major contributors to clinical syndromes of respiratory disease in cats. Because the trigger for many bronchiolar disorders is environmental and humans live in a shared environment with similar susceptibility, understanding these diseases in pet cats has relevance to One Health. Thoracic radiography, the major imaging modality used in the diagnostic evaluation of respiratory disease in cats, has low utility in detection of bronchiolar disease. Computed tomography (CT) with paired inspiratory and expiratory scans can detect pathology centered on small airways. In humans, treatment of bronchiolar disorders is not well established because of heterogeneous presentations and often late definitive diagnosis. A review of the human and veterinary medical literature will serve as the basis for a proposed classification scheme in cats. A case series of cats with CT or histopathologic evidence of bronchiolar lesions or both, either as a primary disorder or secondary to extension from large airway disease or interstitial lung disease, will be presented. Future multi‐institutional and multidisciplinary discussions among clinicians, radiologists, and pathologists will help refine and develop this classification scheme to promote early and specific recognition and optimize treatment.

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Section: Other Primary Bronchiolar Variantsmentioning

confidence: 99%

Perspectives in veterinary medicine: Description and classification of bronchiolar disorders in cats

Reinero

Masseau

Grobman

et al. 2019

Veterinary Internal Medicne

View full text Add to dashboard Cite

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“…45,46 Connective tissue disease-associated ILD often shares morphologic features with CHP, occasionally including peribronchiolar fibrosis and peripheral lobular fibrosis. In our experience, many lymphoid aggregates and/or lymphoid aggregates with germinal centers and a high proportion of plasma cells in the interstitial inflammatory infiltrate suggest a diagnosis of a connective tissue disease-associated ILD, whereas peribronchiolar metaplasia is much more common in CHP.…”

Section: Other Differential Diagnosesmentioning

confidence: 99%

Pathology of Chronic Hypersensitivity Pneumonitis What Is It? What Are the Diagnostic Criteria? Why Do We Care?

Churg

Bilawich

Wright

2017

Archives of Pathology &Amp; Laboratory Medicine

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Context.— Chronic hypersensitivity pneumonitis (CHP) has emerged from obscurity during the past 15 years and is now recognized as a very common form of fibrosing interstitial pneumonia but one that is frequently misdiagnosed both clinically and on surgical lung biopsy as usual interstitial pneumonia/idiopathic pulmonary fibrosis (UIP/IPF) or fibrotic nonspecific interstitial pneumonia. Objective.— To review the pathologic features of CHP. Data Sources.— Clinical, pathology, and radiology literature were used. Conclusions.— Upper lobe–predominant fibrosis and/or air-trapping on computed tomography scan are features of CHP but not UIP/IPF; however, radiologic separation is possible in only about 50% of cases. Morphologically, CHP sometimes mimics UIP/IPF, but CHP often shows isolated foci of peribronchiolar (centrilobular) fibrosis, frequently associated with fibroblast foci, and in CHP, fibrosis may bridge from the centrilobular region to another bronchiole, an interlobular septum, or the pleura (“bridging fibrosis”). This set of findings is uncommon in UIP/IPF. In addition, CHP may produce a picture of fibrotic nonspecific interstitial pneumonia. Although giant cells/granulomas are usually present in subacute hypersensitivity pneumonitis, they are much less frequently found in CHP, and their absence does not contradict the diagnosis. This diagnostic separation is clinically important because CHP is treated differently than UIP/IPF is (immunosuppressive agents versus antifibrotic agents); further, there are some data to suggest that removing the patient from antigen exposure improves outcome, and there is evidence that patients with CHP have a much better survival prognosis after lung transplantation than do patients with UIP/IPF. In most cases, accurate diagnosis of CHP requires consultation among clinicians, radiologists, and pathologists.

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“…64 Chronic opioid dependence may also result in delayed gastric emptying and a higher risk of aspirating residual gastric contents. 66 Alcoholism, seizures, anesthesia, and head trauma provoke an altered level of consciousness and serve as additional risk factors for aspiration.…”

Section: Identification Of Patients In Respiratory Compromise Due To mentioning

confidence: 99%

“…Radiation-induced tissue damage may cause loss of sensation in the larynx accompanied with failed epiglottic inversion and poor laryngeal elevation with failed clearance of aspirate. 66 Other disorders of the esophagus and gastrointestinal tract (eg, tumors, strictures, fistulae, achalasia, and obstruction) predispose individuals to aspiration. Additional gastrointestinal disorders include vomiting, obstruction, ascites, gastroparesis, and ileus.…”

Section: Identification Of Patients In Respiratory Compromise Due To mentioning

confidence: 99%

Respiratory Compromise as a New Paradigm for the Care of Vulnerable Hospitalized Patients

et al. 2017

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Acute respiratory compromise describes a deterioration in respiratory function with a high likelihood of rapid progression to respiratory failure and death. Identifying patients at risk for respiratory compromise coupled with monitoring of patients who have developed respiratory compromise might allow earlier interventions to prevent or mitigate further decompensation. The National Association for the Medical Direction of Respiratory Care (NAMDRC) organized a workshop meeting with representation from many national societies to address the unmet needs of respiratory compromise from a clinical practice perspective. Respiratory compromise may arise de novo or may complicate preexisting lung disease. The group identified distinct subsets of respiratory compromise that present similar opportunities for early detection and useful intervention to prevent respiratory failure. The subtypes were characterized by the pathophysiological mechanisms they had in common: impaired control of breathing, impaired airway protection, parenchymal lung disease, increased airway resistance, hydrostatic pulmonary edema, and right-ventricular failure. Classification of acutely ill respiratory patients into one or more of these categories may help in selecting the screening and monitoring strategies that are most appropriate for the patient's particular pathophysiology. Standardized screening and monitoring practices for patients with similar mechanisms of deterioration may enhance the ability to predict respiratory failure early and prevent its occurrence.

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Diffuse aspiration bronchiolitis: analysis of 20 consecutive patients

Cited by 21 publications

References 21 publications

Perspectives in veterinary medicine: Description and classification of bronchiolar disorders in cats

Perspectives in veterinary medicine: Description and classification of bronchiolar disorders in cats

Pathology of Chronic Hypersensitivity Pneumonitis What Is It? What Are the Diagnostic Criteria? Why Do We Care?

Respiratory Compromise as a New Paradigm for the Care of Vulnerable Hospitalized Patients

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