Respiratory bronchiolitis interstitial lung disease (R picture) is a disorder characterized by inflammation of the small airways and interstitial lung disease that occurs in smokers.

R picture is a form of idiopathic interstitial pneumonia.

Respiratory bronchiolitis interstitial lung disease (R picture) is a disorder characterized by inflammation of the small airways and interstitial lung disease that occurs in smokers. R picture is a form of idiopathic interstitial pneumonia. Most smokers develop subclinical bronchiolitis, which is characterized by a mild or moderate inflammation of the small airways. In the few patients who develop severe inflammation with clinically significant interstitial disease, it is called an (R picture). The ratio men: women is 2: 1. The R picture is characterized histologically by a submucosal inflammation of the membranous and respiratory bronchioles, which is characterized by the presence of brown pigmented macrophages (as an expression of an increased iron content, such as in smokers typical), and mucostasis metaplastic cubic epithelial cells in the bronchioles and alveoli. Always occurs a scarring of the alveolar walls. However, similar findings (usually by mineral dusts) occur, viral infections and drug reactions, with some hypersensitivity reactions, occupational inhalation exposure. The R picture histologically also resembles the desquamative interstitial pneumonia, the inflammatory response in r picture but occurs focally and is less extensive. The similarity of these two diseases has led to the assumption that they represent different manifestations of the same disease caused by cigarette smoking. The symptoms with cough and shortness of breath during exercise is similar to the other interstitial lung disease, esp. Of idiopathic pulmonary fibrosis, however, is less pronounced. Humidity RG are the only findings on physical examination. Diagnostic chest X-ray, high-resolution CT (HRCT) Sometimes surgical lung biopsy at diagnosis should be considered in patients who are examined for interstitial lung disease. The diagnostic testing includes imaging and biopsy. To the chest x-ray findings include the following: Diffuse, fine reticular or nodular opacities bronchial wall thickening prominent interstitial space around the bronchial tubes Small regular and irregular opacities Small peripheral ring shadow When HRCT often show centrilobular node and patchy areas of hazy ground glass opacities. In lung function tests often there is a mixed obstructive-restrictive ventilatory disorder. However, the finding may be normal or show an isolated increase in residual volume. The routine laboratory parameters do not help. Smoking cessation therapy The treatment consists of smoking cessation and avoidance of passive cigarette smoking, which can lead to an improvement of the disease or prevent recurrence. There are only a few case reports that confirm the effectiveness of corticosteroids. The natural history of the disease is unknown, but the prognosis is good for smoking cessation.

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