After 25 years of knowing extrinsic allergic bronchioalveolitis we are still dealing with the chronic forms of the disease with pulmonary fibrosis. Due to immunopthogenetic mechanisms, which can not ...always be recognised by standard diagnostic procedures, acute and subacute forms of the disease are often unrecognised and misdiagnosed. Therefore new methods are developed to detect the disease in it's acute phase, which is reversible. In the article, recent knowledge about the etiopatogenesis of extrinsic allergic bronchioloalveolitisis presented, followed by clinical methods of detection ofacute forms of the disease: high resolution computer tomography, bronchoalveolar lavage analysis and lung biopsy. The acute phase is characterised by the Arthus phenomenon in bronchioli and alveoli, while in chronic phase the bronchiolocentrical infiltration with lymphocytes and plasmacells together with granuloma formation is found. Two case reports are presented in the article, one of acute and the other of chronic disease. Moulds are the most common cause of extrinsic allergic bronchioloalveolitis. According bronchoalveolar lavage analysis, CD8 lymphocytes have a predominant role in the pathogenesis. Preventive and therapeutic reccomendations are also presented. Despite its name, extrinsic allergic bronchioloalveolitis is not anatopic disease. It is characterised by complex immunological mechanisms, which lead to lung fibrosis if unrecognised in the early stage. Due to modern clinical methods acute forms of the disease can be detected and successfully treated.
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