HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS REGISTER		Author Keyword(s) Vol Page [Advanced]

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this link to a friend Similar articles in this journal Similar articles in PubMed Add article to my folders Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Ohtani, Y Articles by Yoshizawa, Y Search for Related Content PubMed PubMed Citation Articles by Ohtani, Y Articles by Yoshizawa, Y

Chronic bird fancier’s lung: histopathological and clinical correlation. An application of the 2002 ATS/ERS consensus classification of the idiopathic interstitial pneumonias

¹ Integrated Pulmonology, Tokyo Medical and Dental University, Tokyo, Japan
² Department of Pathology, Juntendou University Hospital, Tokyo, Japan
³ Laboratory of Anatomic Pathology, Kyoto University Hospital, Kyoto, Japan
⁴ Department of Pneumology/Allergy, Ruhrlandklinik, Essen, Germany

Correspondence to:
Correspondence to:
Professor Y Yoshizawa
Integrated Pulmonology, Tokyo Medical and Dental University, 5-45, Yushima 1-chome, Bunkyo-ku, Tokyo 113-8519, Japan; yoshizawa.pulm{at}tmd.ac.jp

Background: Chronic bird fancier’s lung (BFL) has often been misdiagnosed as one of the idiopathic interstitial pneumonias (IIPs).

Methods: To define the clinical and pathological characteristics of chronic BFL, 26 patients with chronic BFL from whom a surgical lung biopsy specimen was taken between October 1992 and June 2001 were evaluated. The histopathological characteristics of the surgical lung biopsy specimens were examined and correlations between the histopathology and clinical characteristics were analysed. The quality of chronic inflammatory and fibrotic changes was expressed according to the 2002 ATS/ERS consensus classification of IIPs.

Results: Two patients were diagnosed as having bronchiolitis obliterans organising pneumonia (BOOP)-like lesions, five as having cellular non-specific interstitial pneumonia (NSIP)-like lesions, and eight as having fibrotic NSIP-like lesions. The other 11 patients were considered to have usual interstitial pneumonia (UIP)-like lesions because of the temporal heterogeneous appearances of the fibrotic changes. However, fibrosis in these patients had developed in centrilobular as well as perilobular areas, suggestive of hypersensitivity pneumonitis. Nineteen patients (73.1%) had multinucleated giant cells, often with cholesterol clefts, while only five patients (19.2%) had granulomas. Patients with BOOP-like or cellular NSIP-like lesions tended to have recurrent acute episodes, whereas patients with UIP-like lesions had an insidious onset. Patients with BOOP-like or cellular NSIP-like lesions had a more favourable outcome than those with fibrotic NSIP-like and UIP-like lesions.

Conclusions: The qualities of chronic inflammatory and fibrotic lesions vary significantly among patients with chronic BFL but correlate with clinical features and prognosis.

Abbreviations: BFL, bird fancier’s lung; BOOP, bronchiolitis obliterans organising pneumonia; HP, hypersensitivity pneumonitis; IIP, idiopathic interstitial pneumonia; NSIP, non-specific interstitial pneumonia; UIP, usual interstitial pneumonia

Keywords: bird fancier’s lung; hypersensitivity pneumonitis; usual interstitial pneumonia; non-specific interstitial pneumonia; bronchiolitis obliterans organising pneumonia

This article has been cited by other articles:

				S. Trahan, V. Hanak, J. H. Ryu, and J. L. Myers Role of Surgical Lung Biopsy in Separating Chronic Hypersensitivity Pneumonia From Usual Interstitial Pneumonia/Idiopathic Pulmonary Fibrosis: Analysis of 31 Biopsies From 15 Patients Chest, July 1, 2008; 134(1): 126 - 132. [Abstract] [Full Text] [PDF]

				T. M. Maher, A. U. Wells, and G. J. Laurent From the authors Eur. Respir. J., May 1, 2008; 31(5): 1142 - 1143. [Full Text] [PDF]

				C. I. S. Silva, N. L. Muller, D. A. Lynch, D. Curran-Everett, K. K. Brown, K. S. Lee, M. P. Chung, and A. Churg Chronic Hypersensitivity Pneumonitis: Differentiation from Idiopathic Pulmonary Fibrosis and Nonspecific Interstitial Pneumonia by Using Thin-Section CT Radiology, January 1, 2008; 246(1): 288 - 297. [Abstract] [Full Text] [PDF]

				C. I. S. Silva, A. Churg, and N. L. Muller Hypersensitivity Pneumonitis: Spectrum of High-Resolution CT and Pathologic Findings Am. J. Roentgenol., February 1, 2007; 188(2): 334 - 344. [Abstract] [Full Text] [PDF]

				N. Khalil, A. Churg, N. Muller, and R. O'Connor Environmental, Inhaled and Ingested Causes of Pulmonary Fibrosis Toxicol Pathol, January 1, 2007; 35(1): 86 - 96. [Abstract] [Full Text] [PDF]

				P. Dawkins, A. Robertson, W. Robertson, V. Moore, J. Reynolds, G. Langman, E. Robinson, J. Harris-Roberts, B. Crook, and S. Burge An outbreak of extrinsic alveolitis at a car engine plant Occup. Med., December 1, 2006; 56(8): 559 - 565. [Abstract] [Full Text] [PDF]

				G. Tino Clinical Year in Review IV: Interstitial Lung Disease, Cystic Fibrosis, Pulmonary Infections, and Mycobacterial Disease Proceedings of the ATS, November 1, 2006; 3(8): 650 - 653. [Full Text] [PDF]

				S J Bourke Interstitial lung disease: progress and problems. Postgrad. Med. J., August 1, 2006; 82(970): 494 - 499. [Abstract] [Full Text] [PDF]

				F. J. Martinez Idiopathic Interstitial Pneumonias: Usual Interstitial Pneumonia versus Nonspecific Interstitial Pneumonia. Proceedings of the ATS, January 1, 2006; 3(1): 81 - 95. [Abstract] [Full Text] [PDF]