Surgical Pathology Criteria

Follicular Bronchiolitis / Bronchitis

Differential Diagnosis

Lymphocytic Interstitial Pneumonitis Follicular Bronchiolitis
Predominantly T cell infiltrate Prominent B cell follicles
Predominantly interalveolar Predominantly peribronchiolar
Occasional caess will show features of both

 

Follicular Bronchiolitis Extranodal Marginal Zone B Cell Lymphoma
Predominantly germinal centers Monomorphous infiltrate
Involvement of pleura and cartilage rare Pleura and cartilage may be involved
Dutcher bodies not seen Dutcher bodies may be seen
Polyclonal Monoclonal

 

Follicular Bronchiolitis Nodular Lymphoid Hyperplasia
Scattered follicles around bronchioles Numerous germinal centers form mass lesion or lesions

 

Follicular Bronchiolitis Hypersensitivity Pneumonitis
Fibroplasia is not typically seen Interstitial fibroblastic foci and intra-airway BOOP-like plugs usually present
No granulomas or giant cells Granulomas and giant cells generally present but may be infrequent in late stage
No fibrosis May develop peri-bronchiolar fibrosis with honeycomb change in later stage

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