Bronchiolitis obliterans (BO) is a chronic inflammatory disease of the
small airways
characterized by
Caused by either
infectious and non-infectious causes. common causes:
Inhalational
chemicals,
fumes, or
toxic gases
Infectious Causes:
Respiratory Infections:
viruses such as
adenovirus,
influenza, and
respiratory syncytial virus (RSV),
Inflammation
Immune
Collagen Vascular Disease
Graft vs Host
.Idiopathic Bronchiolitis Obliterans:
Obliterative Bronchiolitis aka (bronchiolitis obliterans is also known and constrictive bronchiolitis) association to lung transplant and bone marrow transplant
Obliterative bronchiolitis after bone marrow transplantation in a 47-year-old man with myeloma. (a) Expiratory high-resolution CT scan shows diffuse centrilobular nodules connected to branching linear opacities bilaterally. Note the air trapping in the right lower lobe. (b) Photomicrograph (original magnification, ×200; hematoxylin-eosin stain) of a specimen from open lung biopsy shows the bronchiolar walls surrounded by concentric chronic inflammatory infiltrates (arrows). Obliterative bronchiolitis after bone marrow transplantation in a 47-year-old man with myeloma. (a) Expiratory high-resolution CT scan shows diffuse centrilobular nodules connected to branching linear opacities bilaterally. Note the air trapping in the right lower lobe. (b) Photomicrograph (original magnification, ×200; hematoxylin-eosin stain) of a specimen from open lung biopsy shows the bronchiolar walls surrounded by concentric chronic inflammatory infiltrates (arrows).Rossi, SE et al Tree-in-Bud Pattern at Thin-Section CT of the Lungs: Radiologic-Pathologic Overview RadioGraphics Vol. 25, No. 3 2005
CT Scleroderma Obliterative Bronchiolitis vs
CT Scleroderma Obliterative Bronchiolitis 39-year-old-male with a history of scleroderma associated with ILD and digital vasculopathy with ulcers. Coronal CT shows thickening of the segmental and subsegmental airway supplying the lateral basal segment of the left lower lobe. In addition there is a background of peripheral ground glass changes poorly defined ground glass centrilobular nodules and mild reticulation. In this clinical setting obliterative bronchiolitis (aka bronchiolitis obliterans aka constrictive bronchiolitis) is suggested. Cellular NSIP is also a radiological consideration. Ashley Davidoff MD TheCommonVein.net 132Lu 136669c
CT Scleroderma Obliterative Bronchiolitis vs Cellular NSIP 39-year-old-male with a history of scleroderma associated with ILD and digital vasculopathy with ulcers. Axial CT shows thickening of the segmental, subsegmental and small airways supplying the posterior basal segment of the right lower lobe. In addition there is a background poorly defined ground glass changes and mild reticulation. In this clinical setting obliterative bronchiolitis (aka bronchiolitis obliterans aka constrictive bronchiolitis) is suggested. Cellular NSIP is also a radiological consideration. Ashley Davidoff MD TheCommonVein.net 132Lu 136669c
CT Scleroderma Obliterative Bronchiolitis vs Cellular NSIP 39-year-old-male with a history of scleroderma associated with ILD and digital vasculopathy with ulcers. Coronal CT at the level of the spine shows extensive ground glass in the lower lung fields, with subpleural sparing better visualized on the left. Ill defined ground glass centrilobular nodules and mosaic attenuation suggest small airway disease. In this clinical setting obliterative bronchiolitis (aka bronchiolitis obliterans aka constrictive bronchiolitis) and cellular NSIP are radiological considerations. Ashley Davidoff MD TheCommonVein.net 132Lu 136667
References and Links
TCV