brochiolitis - Bronchiolar disorders Current perspective on...

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Unformatted text preview: Bronchiolar disorders: Current perspective on diagnosis & management Puneet Malhotra Senior Resident, Dept. of Pulmonary Medicine, PGIMER • Anatomic considerations • Classification • Diagnostic approach • Specific disorders • Quiz Anatomic considerations • Bronchioles are airways distal to those containing cartilage • Terminal: last purely conducting airways • Respiratory: in relation to alveoli lie within center of 2 pulmonary lobule • Normal bronchioles (0.6mm) not visible on CT Classification of Bronchiolar disorders • Aetiologic • Pathologic • Clinicopathological • HRCT Aetiologic classification • Inhalational injury toxic gases, cigarette smoke, mineral dusts, organic dusts, fire smoke • Postinfectious • Drug induced ampho B, amiodarone, bleomycin, carbamazepine, cephalosporins, IFN- α, mtx, penicillamine, Paraquat • Idiopathic No assoc. disease (BO, BOOP, DPB) Assoc. with other disease (organ Tx, CTD, others) Pathologic classification Colby , AJCP 1998 • Cellular bronchiolitis Cellular bronchiolitis (Infectious, HP, FB, DPB) Respiratory bronchiolitis (RB, RB-ILD,DIP) • Constrictive bronchiolitis Constrictive bronchiolitis/ BO Constrictive bronchiolitis with polyps/ BOOP HRCT classification Muller, Radiology 1995 • Tree-in-bud pattern Asthma, ABPA Infections (bacterial, Mycoplasma,Chlamydia,TB, CMV, PCP) Diffuse panbronchiolitis • Centrilobular nodules HP, RB-ILD, FB, sarcoidosis, LIP, CTD • Decreased lung attenuation BO • Ground-glass opacity and/or consolidation BOOP Clinico-pathological classification Ryu et al, AJRCCM, 2003 • Primary bronchiolar disorders BO, DPB, RB, FB, Mineral dust airway disease, others...
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This note was uploaded on 12/03/2011 for the course MEDICINE 350 taught by Professor Dr.aslam during the Winter '07 term at Medical College.

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brochiolitis - Bronchiolar disorders Current perspective on...

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