The Clinical Characteristics and Outcomes of Follicular Bronchiolitis in Chinese Adult Patients

Follicular bronchiolitis (FB) is a rare interstitial lung disease (ILD) and has been reported in diverse clinical contexts. Six FB patients demonstrated by surgical lung biopsy (SLB) were reviewed between 2009 and 2017 from Nanjing Drum Tower Hospital in China. The average age of subjects was 42 years old (range: 31-55 years). The clinical symptoms were very mild. The laboratory findings showed elevated Erythrocyte sedimentation rate (ESR) and serum globulin and anemia. Pulmonary function tests were normal in four cases. Five cases had underlying diseases, such as, Sjogren's syndrome, multi-centric castlemans' disease, idiopathic pneumonia with autoimmune features and abscess. Five cases presented as interstitial lung disease (ILD) on chest imaging with centrilobular or peribronchiolar nodules, ground glass opacities, interlobular septal thickening, cysts and bronchiectasis. Isolated mass was in one patient. The histopathology suggested the changes of FB in all subjects. Prednisone and/or cyclophosphamide were used in four cases, one did the surgery and the other was clinically monitored. All cases were alive at the end of follow up. The adult patients of FB usually have mild symptoms, ILD and underlying diseases. The definite diagnosis needs SLB. The prognosis is depended on their underlying conditions.