Respiratory bronchiolitis-interstitial lung disease: A rare complication of smoking
Journal Paper/Review - Jul 15, 2022
Isic Elmina, Rassouli Frank, Rodriguez Regulo, Kluckert Jörg-Thomas, Brutsche Martin
A 58-year-old male and a 52-year-old female, both active smokers, presented an incidental finding of bilateral miliary, centrilobular, diffuse ground glass-like opacities on their chest CT. The differential diagnosis
is broad and includes miliary tuberculosis and vasculitis and could be ruled out after bronchoalveolar lavage and transbronchial biopsies. Lung cryobiopsy revealed interstitial and intraalveolar accumulation of
brownish pigmented alveolar macrophages with small, fine-granular, anthracotic particles, i.e. “smokers
macrophages”. The diagnosis of bronchiolitis-interstitial lung disease was retained at the institutional multidisciplinary ILD-board. Partial and complete remission was observed after smoking cessation.