Morphologic diversity of chronic pigeon breeder's disease: clinical features and survival.

Summary Morphology in chronic HP is characterized by bronchiolocentric mononuclear inflammation, poorly formed granulomas and variable degree of fibrosis. However, recent findings suggest that this disease may present different pathologic patterns. In this study we evaluated the clinical behavior and survival of patients with pigeon breeder’s disease according to the pathologic pattern. One-hundred ten biopsies were classified as “typical” ( n  = 58), non-specific interstitial pneumonia (NSIP)-pattern ( n  = 22), usual interstitial pneumonia (UIP)-like ( n  = 10), mixed pattern ( n  = 9), organizing pneumonia (OP)-pattern ( n  = 3), airway-centered interstitial fibrosis (ACIF)-pattern ( n  = 3), and non-classified ( n  = 5). Clinical features and survival were compared between patients with “typical”, NSIP, and UIP patterns. There were no statistical differences between the groups in age, gender, time of symptoms, smoking, clubbing, and PaO 2 . By the one-way ANOVA test we found differences in the percent of lymphocytes in bronchoalveolar lavage (BAL; p p p  = 0.001). UIP-like patients exhibited the worst survival rate (HR: 4.19; 95% CI: 1.66–14.47; p p Multivariate Cox regression analysis revealed that patients with a UIP-like pattern retained a significantly worse survival (HR: 3.4 (IC 95%: 1.15–10.29; p p  = 0.07). These findings demonstrate that a variety of histopathologic and imaging patterns are seen in PBD, and the presence of a UIP-like pattern confers the worst prognosis.