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Two cases of bronchopulmonary dysplasia of similar appearance in adult monozygotic twin: pathology and computed tomographic findings.

Lee YP, Chun EM, Kim YK, Sung SH - Tuberc Respir Dis (Seoul) (2015)

Bottom Line: They had common histories of pneumonias requiring mechanical ventilations in period of infants.Pathologic findings showed bronchiolar hyperplasia and peribronchiolar fibrosis which was similar to classic BPD patients.It might be reasonable to make close follow-up for BPD patients to evaluate the long-term outcomes of BPD survivors.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea.

ABSTRACT
Bronchopulmonary dysplasia (BPD) is related to decreased lung function throughout life. However, the pathology and radiology pattern of BPD of adults are not documented well yet. In this case report, we present BPD case of an adult monozygotic twin showing nearly identical lesions on chest computed tomography (CT). CT images showed mixed areas of ground-glass and reticular opacities in both lungs. They had common histories of pneumonias requiring mechanical ventilations in period of infants. Pulmonary function test of one patient showed a pulmonary insufficiency with airway obstruction. Pathologic findings showed bronchiolar hyperplasia and peribronchiolar fibrosis which was similar to classic BPD patients. Our twin case report might help provide distinguishing pathology and radiology pattern of an adult pulmonary sequelaes of BPD. It might be reasonable to make close follow-up for BPD patients to evaluate the long-term outcomes of BPD survivors.

No MeSH data available.


Related in: MedlinePlus

Pathologic findings of a patient who had undergone video-assisted thoracic surgery. (A) Lower power field lesions showing bronchiolocentric distribution. Alveolar area is relatively intact (×10). (B) Bronchiolar area showing bronchiolar hyperplasia with cystic dilatation and peribronchiolar fibrosis (×40). (C) Peribronchiolar fibrosis and smooth muscle hyperplasia are noted in dilated bronchioles. Bronchiolar lumen is lined by bronchiolar typed epithelium (×100). (D) Subpleural fibrosis and septal fibrosis aggregation of alveolar macrophages are noted (×40).
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Figure 2: Pathologic findings of a patient who had undergone video-assisted thoracic surgery. (A) Lower power field lesions showing bronchiolocentric distribution. Alveolar area is relatively intact (×10). (B) Bronchiolar area showing bronchiolar hyperplasia with cystic dilatation and peribronchiolar fibrosis (×40). (C) Peribronchiolar fibrosis and smooth muscle hyperplasia are noted in dilated bronchioles. Bronchiolar lumen is lined by bronchiolar typed epithelium (×100). (D) Subpleural fibrosis and septal fibrosis aggregation of alveolar macrophages are noted (×40).

Mentions: Pathological examination of the lung specimen showed accentuated bronchioles due to bronchiolar hyperplasia with cystic dilatation of bronchiolar lumens, reminiscent of congenital pulmonary airway malformation. Also, peribronchiolar fibrosis was present, as well as smooth muscle hyperplasia. Alveolar structures were relatively intact except for focal emphysematous change. These pathologic findings were similar pattern to classic BPD. Some bronchiolar lumens were filled with necro-inflammatory mucoid material, suggestive of superimposed recent bronchiolitis (Figure 2). These findings suggest previous small airway damage, accompanied by recent bronchiolitis. The possibility of cryptogenic organizing pneumonia or other atypical pneumonia could be ruled out by pathologic findings.


Two cases of bronchopulmonary dysplasia of similar appearance in adult monozygotic twin: pathology and computed tomographic findings.

Lee YP, Chun EM, Kim YK, Sung SH - Tuberc Respir Dis (Seoul) (2015)

Pathologic findings of a patient who had undergone video-assisted thoracic surgery. (A) Lower power field lesions showing bronchiolocentric distribution. Alveolar area is relatively intact (×10). (B) Bronchiolar area showing bronchiolar hyperplasia with cystic dilatation and peribronchiolar fibrosis (×40). (C) Peribronchiolar fibrosis and smooth muscle hyperplasia are noted in dilated bronchioles. Bronchiolar lumen is lined by bronchiolar typed epithelium (×100). (D) Subpleural fibrosis and septal fibrosis aggregation of alveolar macrophages are noted (×40).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4388897&req=5

Figure 2: Pathologic findings of a patient who had undergone video-assisted thoracic surgery. (A) Lower power field lesions showing bronchiolocentric distribution. Alveolar area is relatively intact (×10). (B) Bronchiolar area showing bronchiolar hyperplasia with cystic dilatation and peribronchiolar fibrosis (×40). (C) Peribronchiolar fibrosis and smooth muscle hyperplasia are noted in dilated bronchioles. Bronchiolar lumen is lined by bronchiolar typed epithelium (×100). (D) Subpleural fibrosis and septal fibrosis aggregation of alveolar macrophages are noted (×40).
Mentions: Pathological examination of the lung specimen showed accentuated bronchioles due to bronchiolar hyperplasia with cystic dilatation of bronchiolar lumens, reminiscent of congenital pulmonary airway malformation. Also, peribronchiolar fibrosis was present, as well as smooth muscle hyperplasia. Alveolar structures were relatively intact except for focal emphysematous change. These pathologic findings were similar pattern to classic BPD. Some bronchiolar lumens were filled with necro-inflammatory mucoid material, suggestive of superimposed recent bronchiolitis (Figure 2). These findings suggest previous small airway damage, accompanied by recent bronchiolitis. The possibility of cryptogenic organizing pneumonia or other atypical pneumonia could be ruled out by pathologic findings.

Bottom Line: They had common histories of pneumonias requiring mechanical ventilations in period of infants.Pathologic findings showed bronchiolar hyperplasia and peribronchiolar fibrosis which was similar to classic BPD patients.It might be reasonable to make close follow-up for BPD patients to evaluate the long-term outcomes of BPD survivors.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea.

ABSTRACT
Bronchopulmonary dysplasia (BPD) is related to decreased lung function throughout life. However, the pathology and radiology pattern of BPD of adults are not documented well yet. In this case report, we present BPD case of an adult monozygotic twin showing nearly identical lesions on chest computed tomography (CT). CT images showed mixed areas of ground-glass and reticular opacities in both lungs. They had common histories of pneumonias requiring mechanical ventilations in period of infants. Pulmonary function test of one patient showed a pulmonary insufficiency with airway obstruction. Pathologic findings showed bronchiolar hyperplasia and peribronchiolar fibrosis which was similar to classic BPD patients. Our twin case report might help provide distinguishing pathology and radiology pattern of an adult pulmonary sequelaes of BPD. It might be reasonable to make close follow-up for BPD patients to evaluate the long-term outcomes of BPD survivors.

No MeSH data available.


Related in: MedlinePlus