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. 2008 Apr;3(2):67-75.
doi: 10.4103/1817-1737.39641.

Bronchiolitis obliterans organizing pneumonia: pathogenesis, clinical features, imaging and therapy review

Sara Al-Ghanem  1 , Hamdan Al-Jahdali, Hanaa Bamefleh, Ali Nawaz Khan
Affiliations

Bronchiolitis obliterans organizing pneumonia: pathogenesis, clinical features, imaging and therapy review

Sara Al-Ghanem et al. Ann Thorac Med. 2008 Apr.

Abstract

Bronchiolitis obliterans organizing pneumonia (BOOP) was first described in the early 1980s as a clinicopathologic syndrome characterized symptomatically by subacute or chronic respiratory illness and histopathologically by the presence of granulation tissue in the bronchiolar lumen, alveolar ducts and some alveoli, associated with a variable degree of interstitial and airspace infiltration by mononuclear cells and foamy macrophages. Persons of all ages can be affected. Dry cough and shortness of breath of 2 weeks to 2 months in duration usually characterizes BOOP. Symptoms persist despite antibiotic therapy. On imaging, air space consolidation can be indistinguishable from chronic eosinophilic pneumonia (CEP), interstitial pneumonitis (acute, nonspecific and usual interstitial pneumonitis, neoplasm, inflammation and infection). The definitive diagnosis is achieved by tissue biopsy. Patients with BOOP respond favorably to treatment with steroids.

Keywords: Bronchiolitis; cryptogenic organizing pneumonia; organizing pneumonia.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Case of idiopathic BOOP, shown on low power [magnification × 10] - pale staining areas of elongated branching fibrosis, involving bronchiolar lumen and peribronchial airspaces [solid arrow]. The alveolar septae [inset] shows mild chronic inflammation
Figure 2
Figure 2
Case of BOOP with associated abscess. The pale elongated, serpiginous branching fibrous plugs in the alveolar spaces are demonstrated by the solid arrow. The abscess area is demonstrated by transparent arrow magnified × 40 in the inset. HandE stain, magnification × 10
Figure 3
Figure 3
BOOP presenting as airspace and nodular opacities (L). Typical picture of BOOP with peripheral bilateral airspace opacities, predominantly at the bases (R).
Figure 4
Figure 4
Multiple bilateral airspace and interstitial patchy opacities
Figure 5
Figure 5
Left: endobronchial and acinar filling with tree-in-bud appearance with mild interstitial thickening. Right: Interstitial thickening and airspace opacities as a presentation of BOOP
Figure 6
Figure 6
BOOP presenting as a nodule with partial spiculation (R) and peripheral nodules (L)
See this image and copyright information in PMC

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