Respiratory Bronchiolitis with Fibrosis. High-Resolution Computed Tomography Findings and Correlation with Pathology
Bibliographic record
Abstract
BACKGROUND: Recent pathology studies report that the lungs of cigarette smokers may demonstrate small localized subpleural foci of interstitial fibrosis associated with emphysema. Pathologically, this lesion has been termed smoking-related interstitial fibrosis, respiratory bronchiolitis-interstitial lung disease (ILD) with fibrosis, or airspace enlargement with fibrosis, but it is commonly misinterpreted on imaging and biopsy as a diffuse fibrosing interstitial pneumonia. The high-resolution computed tomography (HRCT) appearance of this process has not been defined. OBJECTIVES: We describe HRCT imaging of seven patients with this lesion present histologically. MEASUREMENTS AND MAIN RESULTS: HRCT features consisted of patchy areas of mild reticulation around predominantly subpleural upper/mid zone emphysematous changes in all cases, with variable patchy ground-glass change in six cases. Pathologically, there were distinctly circumscribed foci of dense, often hyalinized, interstitial fibrosis mixed with emphysema; variable numbers of smoker's macrophages were present in the airspaces. The fibrosis was confined to the subpleural regions. Three patients with follow-up information were clinically stable. CONCLUSIONS: These data suggest that a CT pattern of patchy areas of reticular changes about predominantly upper zone emphysematous spaces may be seen in smokers who do not have clinical evidence of a diffuse ILD. We propose that this lesion be called respiratory bronchiolitis with fibrosis (RBF) to avoid confusion with other forms of ILD. RBF probably accounts for some of the cases of ILD seen in large radiologic surveys of smokers. The pathology literature indicates that RBF either has no functional effects or at worst represents mild, usually nonprogressive disease, and hence separation from other, more serious, forms of ILD is important. Recognition of this lesion on imaging may obviate the need for lung biopsy.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".