An unusual case of interstitial lung disease: Revisiting peribronchiolar metaplasia interstitial lung disease (PBM-ILD).

Peribronchiolar metaplasia (PBM) is a histological finding of uncertain significance commonly seen in interstitial lung disease (ILD). PBM is thought to be secondary to small airway injury from insults such as tobacco smoke and other environmental exposures. The term PBM-ILD has been proposed for patients with ILD where PBM is the major histologic finding, however a lack of radiographic changes supportive of ILD in previously reported cases has limited recognition of the diagnosis. We present a rare case of welding-associated ILD with clinical, radiographic, and histologic evidence consistent with the proposed definition of PBM-ILD. We outline an approach to its consideration as a diagnosis based on our experience through multidisciplinary discussion.

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© 2023 The Authors. Respirology Case Reports published by John Wiley & Sons Australia, Ltd on behalf of The Asian Pacific Society of Respirology.

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Jolene Fisher reports grants from the Canadian Pulmonary Fibrosis Foundation and the University of Toronto, and personal fees from Boehringer‐Ingelheim and AstraZeneca, outside the submitted work. Shane Shapera reports honoraria for speaking engagements and participation in advisory boards with Boehringer‐Ingelheim, Hoffman‐La Roche and AstraZeneca. Micheal McInnis reports personal fees from Bayer and Boehringer‐Ingelheim, outside the submitted work.