Adult bronchiolitis diagnostic study of choice: Difference between revisions
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== Overview == | == Overview == | ||
There is no single diagnostic study of choice for the diagnosis of adult bronchiolitis, but pulmonary function testing, high resolution computed tomography (HRCT), and bronchoscopy may be useful in the diagnosis of adult bronchiolitis. | There is no single diagnostic study of choice for the diagnosis of adult bronchiolitis, but [[Spirometry|pulmonary function testing]], [[Computed tomography|high resolution computed tomography]] (HRCT), and [[bronchoscopy]] may be useful in the diagnosis of adult bronchiolitis. | ||
== Diagnostic Study of Choice == | == Diagnostic Study of Choice == | ||
There is no single diagnostic study of choice for the diagnosis of adult bronchiolitis, but pulmonary function testing, high resolution computed tomography (HRCT), and bronchoscopy may be useful in the diagnosis of adult bronchiolitis.<ref name="pmid20371529">{{cite journal |vauthors=Devakonda A, Raoof S, Sung A, Travis WD, Naidich D |title=Bronchiolar disorders: a clinical-radiological diagnostic algorithm |journal=Chest |volume=137 |issue=4 |pages=938–51 |date=April 2010 |pmid=20371529 |doi=10.1378/chest.09-0800 |url=}}</ref><ref name="pmid16037505">{{cite journal |vauthors=Pipavath SJ, Lynch DA, Cool C, Brown KK, Newell JD |title=Radiologic and pathologic features of bronchiolitis |journal=AJR Am J Roentgenol |volume=185 |issue=2 |pages=354–63 |date=August 2005 |pmid=16037505 |doi=10.2214/ajr.185.2.01850354 |url=}}</ref><ref name="pmid12475532">{{cite journal |vauthors=Jensen SP, Lynch DA, Brown KK, Wenzel SE, Newell JD |title=High-resolution CT features of severe asthma and bronchiolitis obliterans |journal=Clin Radiol |volume=57 |issue=12 |pages=1078–85 |date=December 2002 |pmid=12475532 |doi= |url=}}</ref><ref name="pmid24806161">{{cite journal |vauthors=Barker AF, Bergeron A, Rom WN, Hertz MI |title=Obliterative bronchiolitis |journal=N. Engl. J. Med. |volume=370 |issue=19 |pages=1820–8 |date=May 2014 |pmid=24806161 |doi=10.1056/NEJMra1204664 |url=}}</ref><ref name="pmid18339530">{{cite journal |vauthors=Ghanei M, Tazelaar HD, Chilosi M, Harandi AA, Peyman M, Akbari HM, Shamsaei H, Bahadori M, Aslani J, Mohammadi A |title=An international collaborative pathologic study of surgical lung biopsies from mustard gas-exposed patients |journal=Respir Med |volume=102 |issue=6 |pages=825–30 |date=June 2008 |pmid=18339530 |doi=10.1016/j.rmed.2008.01.016 |url=}}</ref> | There is no single diagnostic study of choice for the diagnosis of adult bronchiolitis, but [[Spirometry|pulmonary function testing]], [[Computed tomography|high resolution computed tomography]] (HRCT), and [[bronchoscopy]] may be useful in the diagnosis of adult bronchiolitis.<ref name="pmid20371529">{{cite journal |vauthors=Devakonda A, Raoof S, Sung A, Travis WD, Naidich D |title=Bronchiolar disorders: a clinical-radiological diagnostic algorithm |journal=Chest |volume=137 |issue=4 |pages=938–51 |date=April 2010 |pmid=20371529 |doi=10.1378/chest.09-0800 |url=}}</ref><ref name="pmid16037505">{{cite journal |vauthors=Pipavath SJ, Lynch DA, Cool C, Brown KK, Newell JD |title=Radiologic and pathologic features of bronchiolitis |journal=AJR Am J Roentgenol |volume=185 |issue=2 |pages=354–63 |date=August 2005 |pmid=16037505 |doi=10.2214/ajr.185.2.01850354 |url=}}</ref><ref name="pmid12475532">{{cite journal |vauthors=Jensen SP, Lynch DA, Brown KK, Wenzel SE, Newell JD |title=High-resolution CT features of severe asthma and bronchiolitis obliterans |journal=Clin Radiol |volume=57 |issue=12 |pages=1078–85 |date=December 2002 |pmid=12475532 |doi= |url=}}</ref><ref name="pmid24806161">{{cite journal |vauthors=Barker AF, Bergeron A, Rom WN, Hertz MI |title=Obliterative bronchiolitis |journal=N. Engl. J. Med. |volume=370 |issue=19 |pages=1820–8 |date=May 2014 |pmid=24806161 |doi=10.1056/NEJMra1204664 |url=}}</ref><ref name="pmid18339530">{{cite journal |vauthors=Ghanei M, Tazelaar HD, Chilosi M, Harandi AA, Peyman M, Akbari HM, Shamsaei H, Bahadori M, Aslani J, Mohammadi A |title=An international collaborative pathologic study of surgical lung biopsies from mustard gas-exposed patients |journal=Respir Med |volume=102 |issue=6 |pages=825–30 |date=June 2008 |pmid=18339530 |doi=10.1016/j.rmed.2008.01.016 |url=}}</ref> | ||
===== Diagnostic results ===== | ===== Diagnostic results ===== | ||
*The following result of pulmonary function test is suggestive of adult bronchiolitis: | *The following result of pulmonary function test is suggestive of adult bronchiolitis: | ||
**Normal PFT | **Normal [[Spirometry|PFT]] ''or'' | ||
**Obstructive or restrictive changes with atelectasis | **Obstructive or restrictive changes with [[atelectasis]] | ||
**Irreversibility following inhaled bronchodilator | **Irreversibility following inhaled bronchodilator | ||
**Decreased carbon monoxide diffusing capacity | **Decreased [[Diffusion capacity|carbon monoxide diffusing capacity]] | ||
*The following result of high resolution CT is suggestive of adult bronchiolitis: | *The following result of high resolution CT is suggestive of adult bronchiolitis: | ||
**Mosaic or diffuse air trapping | **Mosaic or diffuse air trapping | ||
| Line 20: | Line 20: | ||
**Linear opacities | **Linear opacities | ||
**Centrilobular nodules | **Centrilobular nodules | ||
**Bronchiectasis (dilated airways) | **[[Bronchiectasis]] (dilated airways) | ||
***Specifically seen in: | ***Specifically seen in: | ||
****Bronchiolitis obliterans | ****Bronchiolitis obliterans | ||
****Following lung transplant | ****Following lung transplant | ||
****Rheumatic disease | ****[[Rheumatoid arthritis|Rheumatic disease]] | ||
****Previous infection | ****Previous infection | ||
****Toxic fume inhalation | ****Toxic fume inhalation | ||
*Bronchoscopy does not have any specific findings that suggest adult bronchiolitis, however, bronchoscopy may be useful for: | *Bronchoscopy does not have any specific findings that suggest adult bronchiolitis, however, [[bronchoscopy]] may be useful for: | ||
**Identifying features of other respiratory pathologies, such as: | **Identifying features of other respiratory pathologies, such as: | ||
***Increased lymphocytic count in | ***Increased lymphocytic count in [[hypersensitivity pneumonitis]] | ||
***Necrotizing granulomata in sarcoidosis | ***Necrotizing granulomata in [[sarcoidosis]] | ||
***Infection | ***Infection | ||
***Malignancy | ***Malignancy | ||
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===== Sequence of Diagnostic Studies ===== | ===== Sequence of Diagnostic Studies ===== | ||
*The investigation fro adult bronchiolitis should be performed when: | *The investigation fro adult bronchiolitis should be performed when: | ||
**The patient presented with insidious onset of cough and dyspnea, with a pattern unlike chronic obstructive pulmonary disorder and asthma. | **The patient presented with insidious onset of [[cough]] and [[dyspnea]], with a pattern unlike [[Chronic obstructive pulmonary disease|chronic obstructive pulmonary disorder]] and [[asthma]]. | ||
=== Diagnostic Criteria === | === Diagnostic Criteria === | ||
There are no established criteria for the diagnosis of | There are no established criteria for the diagnosis of adult bronchiolitis. | ||
==References== | ==References== | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Hadeel Maksoud M.D.[2]
Overview
There is no single diagnostic study of choice for the diagnosis of adult bronchiolitis, but pulmonary function testing, high resolution computed tomography (HRCT), and bronchoscopy may be useful in the diagnosis of adult bronchiolitis.
Diagnostic Study of Choice
There is no single diagnostic study of choice for the diagnosis of adult bronchiolitis, but pulmonary function testing, high resolution computed tomography (HRCT), and bronchoscopy may be useful in the diagnosis of adult bronchiolitis.[1][2][3][4][5]
Diagnostic results
- The following result of pulmonary function test is suggestive of adult bronchiolitis:
- Normal PFT or
- Obstructive or restrictive changes with atelectasis
- Irreversibility following inhaled bronchodilator
- Decreased carbon monoxide diffusing capacity
- The following result of high resolution CT is suggestive of adult bronchiolitis:
- Mosaic or diffuse air trapping
- Bronchial wall thickening
- Linear opacities
- Centrilobular nodules
- Bronchiectasis (dilated airways)
- Specifically seen in:
- Bronchiolitis obliterans
- Following lung transplant
- Rheumatic disease
- Previous infection
- Toxic fume inhalation
- Specifically seen in:
- Bronchoscopy does not have any specific findings that suggest adult bronchiolitis, however, bronchoscopy may be useful for:
- Identifying features of other respiratory pathologies, such as:
- Increased lymphocytic count in hypersensitivity pneumonitis
- Necrotizing granulomata in sarcoidosis
- Infection
- Malignancy
- Lung transplant function deterioration causes
- Identifying features of other respiratory pathologies, such as:
Sequence of Diagnostic Studies
- The investigation fro adult bronchiolitis should be performed when:
- The patient presented with insidious onset of cough and dyspnea, with a pattern unlike chronic obstructive pulmonary disorder and asthma.
Diagnostic Criteria
There are no established criteria for the diagnosis of adult bronchiolitis.
References
- ↑ Devakonda A, Raoof S, Sung A, Travis WD, Naidich D (April 2010). "Bronchiolar disorders: a clinical-radiological diagnostic algorithm". Chest. 137 (4): 938–51. doi:10.1378/chest.09-0800. PMID 20371529.
- ↑ Pipavath SJ, Lynch DA, Cool C, Brown KK, Newell JD (August 2005). "Radiologic and pathologic features of bronchiolitis". AJR Am J Roentgenol. 185 (2): 354–63. doi:10.2214/ajr.185.2.01850354. PMID 16037505.
- ↑ Jensen SP, Lynch DA, Brown KK, Wenzel SE, Newell JD (December 2002). "High-resolution CT features of severe asthma and bronchiolitis obliterans". Clin Radiol. 57 (12): 1078–85. PMID 12475532.
- ↑ Barker AF, Bergeron A, Rom WN, Hertz MI (May 2014). "Obliterative bronchiolitis". N. Engl. J. Med. 370 (19): 1820–8. doi:10.1056/NEJMra1204664. PMID 24806161.
- ↑ Ghanei M, Tazelaar HD, Chilosi M, Harandi AA, Peyman M, Akbari HM, Shamsaei H, Bahadori M, Aslani J, Mohammadi A (June 2008). "An international collaborative pathologic study of surgical lung biopsies from mustard gas-exposed patients". Respir Med. 102 (6): 825–30. doi:10.1016/j.rmed.2008.01.016. PMID 18339530.