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Reactive pulmonary lymphoid disorders

A G Nicholson1, A C Wotherspoon, T C Diss

  • 1Department of Histopathology, Royal Brompton Hospital, London, UK.

Histopathology
|May 1, 1995
PubMed
Summary
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Reactive pulmonary lymphoid disorders, including lymphoid interstitial pneumonia and follicular bronchitis/bronchiolitis, may represent overlapping immune system hyperplasias. Lymphoma was identified in two cases, confirmed by polymerase chain reaction.

Area of Science:

  • Pulmonary Pathology
  • Immunopathology
  • Oncology

Background:

  • Pulmonary lymphoid disorders encompass lymphoid interstitial pneumonia and follicular bronchitis/bronchiolitis.
  • These conditions present diverse etiologies and pathological features.
  • Understanding their relationship is crucial for accurate diagnosis and management.

Purpose of the Study:

  • To investigate the morphological and immunohistochemical characteristics of lymphoid interstitial pneumonia and follicular bronchitis/bronchiolitis.
  • To explore the potential overlap between these reactive pulmonary lymphoid disorders.
  • To determine the clonality of infiltrates using polymerase chain reaction.

Main Methods:

  • Review of 26 cases diagnosed with lymphoid interstitial pneumonia or follicular bronchitis/bronchiolitis.

Related Experiment Videos

  • Morphological and immunohistochemical analysis of tissue samples.
  • Polymerase chain reaction (PCR) for clonality assessment of lymphoid infiltrates.

    • Main Results:

    • A spectrum of histological changes was observed, with interstitial T-lymphocyte-predominant infiltrates in lymphoid interstitial pneumonia and airway-centered lymphoid follicles in follicular bronchitis/bronchiolitis.
    • Two cases showed features suggestive of lymphoma, with one confirmed by PCR.
    • Most cases exhibited polyclonal patterns, indicating reactive hyperplasia, while one case showed oligoclonal bands.

    Conclusions:

    • Lymphoid interstitial pneumonia and follicular bronchitis/bronchiolitis may represent overlapping patterns of bronchopulmonary immune system hyperplasia.
    • Distinguishing between these entities relies on the dominant pathological component.
    • Polymerase chain reaction is valuable for identifying lymphoma in reactive pulmonary lymphoid disorders.