(aka Pulmonary Lymphoid Hyperplasia)
Etiology
- Primary Pulmonary Lymphoid Hyperplasia
- Secondary Pulmonary Lymphoid Hyperplasia
- Sjogren’s Syndrome (see [[Sjogrens Syndrome]])
- Rheumatoid Arthritis (see [[Rheumatoid Arthritis]])
- AIDS (see [[HIV Disease]])
- Bronchiectasis (see [[Bronchiectasis]])
- Other Infections
Physiology
- Infiltration of bronchiolar or bronchial walls by hyperplastic lymhoid follicles with germinal centers (composed of lymphocytes)
- Represents one of the lymphoproliferative disorders of the lungs (along with LIP, MALTomas, and nodular lymphoid hyperplasia/pseudolymphoma
Pathology
- Lymphoid Hyperplasia: peribronchiolar germinal centers
Diagnosis
- PFT’s: obstruction (distinct from LIP, which usually produces restriction)
- FOB: lymphocytic-predominant BAL (similar to Sarcoid and HP)
- CXR/Chest CT Pattern
- Centrilobular Nodules with Peripheral Tree-In-Bud Pattern: characteristic of bronchiolar disease
- Ground-Glass Opacities:
- Mediastinal Adenopathy: also seen in LIP and Nodular Lymphoid Hyperplasia
Clinical
- Centrilobular Nodules + Ground-Glass Infiltrates with Obstructive PFT’s (see [[Obstructive Lung Disease]] and [[ILD-Etiology]])
- Exertional Dyspnea: typically slowly progressive
Treatment
- Treat Underlying Condition
- Steroids: effective
References
- xxx