Diffuse panbronchiolitis

Diffuse panbronchiolitis (DPB) or Asian panbronchiolitis is an idiopathic progressive inflammatory small airway obstructive lung disease.

There is striking predilection in east Asia (e.g. Japan, Korea, China). It tends to present in middle aged (~ 30-60-year-old) adults, often nonsmokers. There is a high prevalence rate in males with a M:F ratio of ~ 2:1.

It is most likely associated with infections such as H. influenza, P. aeruginosa, and type 1 human T-lymphotropic virus in genetically susceptible people. 

Diffuse panbronchiolitis is characterised by centrilobular peribronchiolar infiltrates of acute and chronic inflammatory cells, which occur principally at the level of the respiratory bronchioles. There can be bronchiolar dilatation and intra-luminal inflammatory exudates. 

Histologically, so called "DPB unit lesion" is comprised of foamy macrophages and lymphoid infiltrates. 

Associations
  • sinusitis
Plain radiograph 

Nonspecific and may show bilateral, diffuse, small nodular shadows with pulmonary hyperinflation.

HRCT Chest

A periphero-basilar predilection may be present. Features are generally non specific and include:

Often treated with long term low dose erythromycin. If untreated can be progressive even leading to death.

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Article Information

rID: 11070
System: Chest
Section: Pathology
Tag: cases
Synonyms or Alternate Spellings:
  • Diffuse panbronchiolitis (DPB)
  • Diffuse pan-bronchiolitis

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