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Congress: ECR24
Poster Number: C-10866
Type: EPOS Radiologist (educational)
DOI: 10.26044/ecr2024/C-10866
Authorblock: J. López Martín, M. M. Merideño García, A. Enriquez Puga, A. A. Gil, E. Ponte, E. F. Berríos, M. S. Paez Alvarez, P. Garcés Marín, A. D. Onuta; Toledo/ES
Disclosures:
Jaime López Martín: Nothing to disclose
María Montaña Merideño García: Nothing to disclose
Andres Enriquez Puga: Nothing to disclose
Asunción Almenar Gil: Nothing to disclose
Elisabetta Ponte: Nothing to disclose
Esnelly Francismaría Berríos: Nothing to disclose
Manuel Sebastian Paez Alvarez: Nothing to disclose
Pablo Garcés Marín: Nothing to disclose
Andrei Daniel Onuta: Nothing to disclose
Keywords: Lung, Respiratory system, Thorax, CT, Plain radiographic studies, Education, Infection, Inflammation, Transplantation
Learning objectives Radiologists frequently encounter bronchiolitis or distal airway pathology on images. This article aims to simplify the concept of bronchiolitis and facilitate the formulation of a concise and accurate differential diagnosis. We will describe the entities encompassed within the distal airway pathology, distinguishing between cellular and constrictive bronchiolitis. Likewise, we will review the characteristic clinical data typically associated with each entity.
Read more Background Bronchiolitis or small airways disease refers to injury affecting the bronchioles and alveolar ducts, leading to inflammation or fibrosis. Bronchioles are small airways with a diameter of 2 mm or less located at the center of the secondary pulmonary lobule (SPL). Normally, these small airways are imperceptible on imaging but become visible when abnormal (fig.1). [fig 1] SPL is the functional unit of the lung and is key to comprehending chest terminology and physiology of multiple diseases. A nuanced knowledge of the distribution...
Read more Findings and procedure details Even though there is no consensus classification system for small airways disease, one of the most accepted and used at pathologic examinations divides these conditions into two broad categories: cellular bronchiolitis (CB) and constrictive or fibrotic bronchiolitis (FB).Histologically, CB is characterized by inflammatory cells as the predominant feature, in contrast to FB, which refers to bronchiolar narrowing due to adventitial and submucosal fibrosis.Various forms of CB are well acknowledged, encompassing infectious bronchiolitis (IB), respiratory bronchiolitis (RB), aspiration bronchiolitis (AB), follicular...
Read more Conclusion Bronchiolitis, encompassing a spectrum of airway pathologies with significant clinical impact and varying treatments, poses a challenge for radiologists due to the frequent overlap of imaging findings. These pathologies are categorized into cellular bronchiolitis, characterized by centrilobular nodules with or without a 'tree-in-bud' pattern, and fibrotic bronchiolitis, associated with mosaic attenuation pattern. Within cellular bronchiolitis, numerous entities exhibit distinct imaging findings and associated clinical data that aid in diagnosis. Fibrotic bronchiolitis represents a pattern often associated with a clear clinical...
Read more References Abbott GF, Rosado-de-Christenson ML, Rossi SE, Suster S. Imaging of small airways disease. J Thorac Imaging. 2009 Nov;24(4):285-98. doi: 10.1097/RTI.0b013e3181c1ab83. PMID: 19935225. Berniker AV, Henry TS. Imaging of Small Airways Diseases. Radiol Clin North Am. 2016 Nov;54(6):1165-1181. doi: 10.1016/j.rcl.2016.05.009. Epub 2016 Aug 11. PMID: 27719982. Department of Radiology, Hospital Universitario de Toledo. Kang EY, Woo OH, Shin BK, Yong HS, Oh YW, Kim HK. Bronchiolitis: classification, computed tomographic and histopathologic features, and radiologic approach. J Comput Assist Tomogr. 2009 Jan-Feb;33(1):32-41. doi: 10.1097/RCT.0b013e3181635e50. PMID:...
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