The following two pictures were taken from another patient. This bronchiole is markedly constricted by the surrounding lymphoid tissue, which is confined to the airway interstitium. Sato A, Hayakawa H, Uchiyama H, Chida K. Cellular distribution of bronchus-associated lymphoid tissue in rheumatoid arthritis. In this case there is no follicular lymphoid hyperplasia although there is a chronic inflammatory infiltrate between the bronchiole and the vessel. Note the marked narrowing of the artery by intimal fibrosis and inflammation.
Symptoms are similar in both types of bronchiolitis.
There is gradual progression of cough and dyspnea over months to years with minimal sputum except during infections. Airflow limitation not relieved by bronchodilators is present. There may also be a restrictive abnormality. Plain radiographs may be normal. Expiratory HRCTs show mosaic attenuation due to patchy air trapping.