Respiratory bronchiolitis in smokers with spontaneous pneumothorax

Respiratory bronchiolitis (RB) is defined by the accumulation of pigmented macrophages in the lumen and wall of respiratory and membranous bronchioles of smokers. The aim of this study was to determine whether spontaneous pneumothorax was associated with a high prevalence of RB. Seventy-nine consecutive patients who underwent a surgical procedure (thoracotomy or thoracoscopy) for recurrence or persistence of primary spontaneous pneumothorax despite thoracic drainage were studied retrospectively. RB was found in 70 of 79 (88.6%) smokers operated for spontaneous pneumothorax. Associated interstitial pathological abnormalities were present in 53 of 79 cases (67.1%). In nine patients, the pathological lesions were severe and resembled desquamative interstitial pneumonia. Emphysematous lesions were present in about one-third of the patients. Although the possible pathophysiological consequences of respiratory bronchiolitis remain speculative, this study demonstrates the high prevalence of this pathological abnormality in patients with pneumothorax requiring surgical treatment.

This article has been cited by other articles:

				Y.-L. Cheng, T.-W. Huang, C.-K. Lin, S.-C. Lee, C. Tzao, J.-C. Chen, and H. Chang The impact of smoking in primary spontaneous pneumothorax J. Thorac. Cardiovasc. Surg., July 1, 2009; 138(1): 192 - 195. [Abstract] [Full Text] [PDF]

				A. U Wells, A. G Nicholson, and D. M Hansell Challenges in pulmonary fibrosis {middle dot} 4: Smoking-induced diffuse interstitial lung diseases Thorax, October 1, 2007; 62(10): 904 - 910. [Abstract] [Full Text] [PDF]

				J.-F. Cordier Challenges in pulmonary fibrosis {middle dot} 2 : Bronchiolocentric fibrosis Thorax, July 1, 2007; 62(7): 638 - 649. [Abstract] [Full Text] [PDF]

				M. Nakanishi, Y. Demura, S. Mizuno, S. Ameshima, Y. Chiba, I. Miyamori, H. Itoh, M. Kitaichi, and T. Ishizaki Changes in HRCT findings in patients with respiratory bronchiolitis-associated interstitial lung disease after smoking cessation Eur. Respir. J., March 1, 2007; 29(3): 453 - 461. [Abstract] [Full Text] [PDF]

				C. E. Girod and T. E. King Jr. COPD: A Dust-Induced Disease? Chest, October 1, 2005; 128(4): 3055 - 3064. [Abstract] [Full Text] [PDF]

				A. De Smedt, E. Vanderlinden, C. Demanet, M. De Waele, A. Goossens, and M. Noppen Characterisation of pleural inflammation occurring after primary spontaneous pneumothorax Eur. Respir. J., June 1, 2004; 23(6): 896 - 900. [Abstract] [Full Text] [PDF]

				H. J. M. Smit, R. P. Golding, F. M. N. H. Schramel, W. L. Deville, R. A. Manoliu, and P. E. Postmus Lung Density Measurements in Spontaneous Pneumothorax Demonstrate Airtrapping Chest, June 1, 2004; 125(6): 2083 - 2090. [Abstract] [Full Text] [PDF]

				M. Selman The Spectrum of Smoking-Related Interstitial Lung Disorders: The Never-Ending Story of Smoke and Disease Chest, October 1, 2003; 124(4): 1185 - 1187. [Full Text] [PDF]

				M. Selman, T. E. King Jr., and A. Pardo Idiopathic Pulmonary Fibrosis: Prevailing and Evolving Hypotheses about Its Pathogenesis and Implications for Therapy Ann Intern Med, January 16, 2001; 134(2): 136 - 151. [Abstract] [Full Text] [PDF]