HIV associated follicular bronchiolitis
HIV associated follicular bronchiolitis is a form of bronchiolitis that occurs in those with HIV.
It has been described in both HIV-positive children and adults.
It is manifested by bronchial-associated lymphoid tissue hyperplasia thought to be due to repetitive antigen stimulation and polyclonal lymphoid expansion. When associated with follicular bronchiolitis, this histopathological pattern is limited to the peribronchiolar area, whereas in lymphoid interstitial pneumonia it extends into the interstitium.
Computed tomography usually shows small (<3 mm) centrilobular nodules and often demonstrates peribronchial nodules. Some patients may have ground-glass changes 3.
Treatment and prognosis
It can have a variable prognosis. However, it can resolve with highly active antiretroviral therapy.
Possible considerations include
- miliary tuberculosis
- disseminated pulmonary fungal disease
- viral pneumonia
- tiny diffuse metastases from cancer
- 1. Ettensohn DB, Mayer KH, Kessimian N, Smith PS. Lymphocytic bronchiolitis associated with HIV infection. Chest. 93 (1): 201-2. Pubmed
- 2. Díaz F, Collazos J, Martinez E, Mayo J. Bronchiolitis obliterans in a patient with HIV infection. Respiratory medicine. 91 (3): 171-3. Pubmed
- 3. Howling SJ, Hansell DM, Wells AU, Nicholson AG, Flint JD, Müller NL. Follicular bronchiolitis: thin-section CT and histologic findings. Radiology. 212 (3): 637-42. doi:10.1148/radiology.212.3.r99se04637 - Pubmed
- 4. Exley CM, Suvarna SK, Matthews S. Follicular bronchiolitis as a presentation of HIV. Clinical radiology. 61 (8): 710-3. doi:10.1016/j.crad.2006.03.016 - Pubmed
- 5. Theron S, Goussard P. Follicular bronchiolitis in an HIV-positive child. Pediatric radiology. 38 (9): 1031. doi:10.1007/s00247-008-0873-2 - Pubmed
- 6. Shipe R, Lawrence J, Green J, Enfield K. HIV-associated follicular bronchiolitis. American journal of respiratory and critical care medicine. 188 (4): 510-1. doi:10.1164/rccm.201206-1096IM - Pubmed