Respiratory bronchiolitis is alung disease associated withtobacco smoking.[1] In pathology, it is defined by the presence of "smoker's macrophages".[1] The accumulation of macrophages is driven by cigarette-smoke-induced oxidative stress, which promotes macrophage recruitment and activation in distal airways.[2] When manifesting significant clinical symptoms it is referred to asrespiratory bronchiolitis interstitial lung disease (RB-ILD).[1]
Pathologic:Lung biopsy with "smoker's macrophages" limited to distal airspaces and peribronchiolar airspaces, and minimal to absent peribronchiolar interstitial fibrotic thickening
It is a histological finding, not a pathological description. When associated with disease, it is known as "Respiratory bronchiolitis-associated interstitial lung disease" or "RB-ILD".[5] Also, this disease is predominantly found in the upper lobe with centrilobar ground glass nodules. Importantly, no fibrosis is involved, just bronchial wall thickening. Treatment is to stop smoking.
^abcdeWilliam Perry, M.D., M.P.H., Kristine Konopka, M.D."Respiratory bronchiolitis".Pathology Outlines.{{cite web}}: CS1 maint: multiple names: authors list (link) Topic Completed: 1 July 2020. Minor changes: 1 July 2020
^Niewoehner, D. E., Kleinerman, J., & Rice, D. B. (1974). Pathologic changes in the peripheral airways of young cigarette smokers. The New England journal of medicine, 291(15), 755–758.https://doi.org/10.1056/NEJM197410102911503
^Cotran, Ramzi S.; Kumar, Vinay; Fausto, Nelson; Nelso Fausto; Robbins, Stanley L.; Abbas, Abul K. (2005).Robbins and Cotran pathologic basis of disease. St. Louis, Mo: Elsevier Saunders. p. 741.ISBN0-7216-0187-1.
