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03:38
Unilateral Lung Volume Analysis Using Micro-CT for Enhanced Assessment of Pulmonary Fibrosis in Preclinical Models
Published on: June 20, 2025
Respiratory bronchiolitis/interstitial lung disease: fibrosis, pulmonary function, and evolving concepts
Andrew Churg1, Nestor L Müller, Joanne L Wright
1Department of Pathology, University of British Columbia, Vancouver, Canada. achurg@interchange.ubc.ca
Archives of Pathology & Laboratory Medicine
|January 16, 2010
Summary
Respiratory bronchiolitis/interstitial lung disease (RBILD) criteria are confusing. RBILD should be diagnosed in smokers with specific functional and imaging findings, distinguishing it from RB and emphysema.
Area of Science:
- Pulmonary Medicine
- Pathology
- Radiology
Background:
- Respiratory bronchiolitis/interstitial lung disease (RBILD) was proposed for interstitial lung disease in smokers with only respiratory bronchiolitis (RB) on biopsy.
- Diagnostic criteria for RBILD have become increasingly complex and debated over time.
Purpose of the Study:
- To critically review and clarify the diagnostic criteria for RBILD.
Main Methods:
- Literature review
- Analysis of personal clinical experience
Main Results:
- RB and RBILD are often histologically and radiologically indistinguishable.
- Mild to marked interstitial fibrosis can be associated with both RB and RBILD.
- RB is common in smokers and linked to airflow obstruction.
- Centrilobular emphysema can present with fibrosis, potentially leading to misclassification as RBILD.
- RBILD diagnosis requires specific clinical, functional, and imaging findings in smokers.
Conclusions:
- RBILD diagnosis should be reserved for smokers with restrictive or mixed lung function, significantly reduced diffusing capacity with minimal airflow obstruction, or characteristic imaging findings and RB on biopsy.
- RB-associated interstitial fibrosis likely contributes to the observed functional abnormalities in these specific cases.
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