CTICasesFollicular Bronchiolitis Associated with Autoimmune Thrombocytopenia
Imaging findings
A woman in her 20s with autoimmune thrombocytopenia has well-defined, predominantly peribronchial nodules, many containing subtle air bronchograms, with some patchy ground glass and a few perilymphatic nodules. A follow-up several months later shows more numerous nodules in the same airway-centric distribution, with discrete margins and identifiable airways within many of them.
Key takeaways
Airway-centric, well-defined nodules with internal air bronchograms that persist and progress over months, once infection is excluded, fit the follicular bronchiolitis / lymphoid hyperplasia spectrum, which has recognized associations with lymphoproliferation and autoimmune disease such as autoimmune thrombocytopenia. Bronchoalveolar lavage can look for lymphocytosis or exclude infection, biopsy is often avoided (especially in ITP), and the process may respond to treatment of the underlying autoimmune disease.
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