CTICasesAsian Panbronchiolitis
Imaging findings
Radiographs demonstrate bilateral, basal-predominant nodular opacities, bronchial wall thickening, and a radial arrangement of bronchial markings, with solid pleural thickening blunting the left costophrenic angle. CT imaging reveals mosaic attenuation representing air trapping, thickened bronchial walls, and diffuse centrilobular nodules corresponding to bronchiolitis concentrated in the mid-to-lower lungs. Long-term follow-up demonstrates persistent mild bronchiectasis with resolution of the small airway centrilobular dots.
Key takeaways
Asian panbronchiolitis (formerly known as diffuse panbronchiolitis) is a chronic inflammatory airway disease most commonly found in individuals of East Asian descent, particularly Japanese and Korean populations. It is strongly associated with specific HLA phenotypes (such as HLA-B54 in Japanese patients) that predispose individuals to an exaggerated inflammatory response to common respiratory pathogens. Treatment involves long-term low-dose macrolide therapy (such as erythromycin), which provides significant clinical improvement and suppresses recurrence.
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