Follicular bronchiolitis

Follicular bronchiolitis (FB) is a nonneoplastic primary polyclonal B cell hyperplasia of the bronchus-associated lymphoid tissue (BALT) due to chronic exposure to antigens in those with underlying collagen vascular or immune deficiency diseases which usually manifested as small centrilobular ground glass nodules with lower lobe distribution. 

It is defined as lymphoid hyperplasia of the BALT and histologically characterised by polyclonal B cell hyperplasia of the lymphoid follicles with reactive germinal centres principally distributed along bronchioles with only minimal infiltration of alveolar septae.

Associations

Many cases of follicular bronchiolitis are associated with various systemic illnesses which include

HRCT chest

A key feature described with follicular bronchiolitis on HRCT includes small ground glass centrilobular nodules of 3mm diameter in lower lobes that are variably associated with peribronchial nodules 1.

Other features (albeit non-specific) include:

Treatment should target the underlying condition as well as administration of steroid and immunosuppressants. The overall prognosis will depend on the underlying or associated abnormality. Some case may respond to macrolide antibiotics 6.

Share article

Article Information

rID: 16671
System: Chest
Tag: cases
Synonyms or Alternate Spellings:
  • Lymphocytic bronchiolitis
  • Follicular bronchiolitis (FB)

Support Radiopaedia and see fewer ads

Cases and Figures

  • Drag
    Case 1: associated with rheumatoid arthritis
    Drag here to reorder.
  • Updating… Please wait.
    Loadinganimation

    Alert accept

    Error Unable to process the form. Check for errors and try again.

    Alert accept Thank you for updating your details.