Bronchiolitis obliterans

High

resolution CT scan showing bronchiolitis obliterans with glass pattern, air trapping, and bronchial thickening

Obliterative

bronchiolitis • Bronchiolitis obliterans - Ganzer Fall bei Radiopaedia

Yu Jin, T. Bronchiolitis obliterans. Case study, Radiopaedia.org. (accessed on 03 Nov 2022) https://doi.org/10.53347/rID-71538 • CC by-nc-sa 3.0 (modified)

Obliterative

bronchiolitis • Air trapping secondary to obliterative bronchiolitis in rheumatoid arthritis - Ganzer Fall bei Radiopaedia

Kwong, Y. Air trapping secondary to obliterative bronchiolitis in rheumatoid arthritis. Case study, Radiopaedia.org. (accessed on 03 Nov 2022) https://doi.org/10.53347/rID-31473 • CC by-nc-sa 3.0 (modified)

Bronchiolitis

obliterans: Infant with reactive airway disease. CXR AP and lateral (above) shows hyperinflation. Axial CT without contrast of the chest shows focal areas of decreased lung density in a lobular patter most prominent in the bilateral upper lobes (below left) and several nodular opacities in the lingula (below right).

pediatricimaging.org • CC-by-nc-sa 4.0

Mosaic

attenuation pattern in lung • Obliterative bronchiolitis - chronic lung allograft dysfunction - Ganzer Fall bei Radiopaedia

Di Muzio, B. Obliterative bronchiolitis - chronic lung allograft dysfunction. Case study, Radiopaedia.org. (accessed on 02 Nov 2022) https://doi.org/10.53347/rID-65183 • CC by-nc-sa 3.0 (modified)

Mosaic

attenuation pattern in lung • Bronchiolitis obliterans - Ganzer Fall bei Radiopaedia

Yu Jin, T. Bronchiolitis obliterans. Case study, Radiopaedia.org. (accessed on 02 Nov 2022) https://doi.org/10.53347/rID-71538 • CC by-nc-sa 3.0 (modified)

Hier werden Begriffe / Krankheitsbilder genannt, die ähnlich sind oder klingen, aber nicht das Gleiche sind.

nicht verwechseln mit: Bronchiolitis obliterans with organising pneumonia (BOOP)

Radiopaedia • CC-by-nc-sa 3.0 • de

Obliterative bronchiolitis (OB), also known as bronchiolitis obliterans or constrictive bronchiolitis, is a type of bronchiolitis and refers to bronchiolar inflammation with submucosal peribronchial fibrosis associated with luminal stenosis and occlusions. OB should not be confused with bronchiolitis obliterans organizing pneumonia (BOOP).

Epidemiology

Associations

Recognized associations include:

inflammatory bowel disease
rheumatoid arthritis: considered the commonest connective tissue disease to be associated with obliterative bronchiolitis
medications, e.g. penicillamine
as a complication following lung transplantation: post lung transplant bronchiolitis obliterans ; can occur in up to 10% of patients, usually within 6-12 months following bone marrow transplantation
Swyer-James syndrome

Clinical presentation

Its cardinal features are progressive breathlessness and a dry cough .

Pathology

The condition is characterized by concentric luminal narrowing of the membranous and respiratory bronchioles as a result of submucosal and peribronchiolar inflammation and fibrosis without any intraluminal granulation tissue or polyps/polyposis. There is an absence of diffuse parenchymal inflammation.

Etiology

It can result from number of causes:

idiopathic/cryptogenic
post-infectious
- post viral (e.g. adenovirus)
- post atypical infection (e.g. Mycoplasma pneumonia)
noxious fume inhalation
neuroendocrine hyperplasia (pulmonary tumourlets)
post-transplant patients
- heart/lung transplants
  - representing the obstructive form of chronic lung allograft dysfunction (CLAD)
- hematopoietic stem cell transplants

Mnemonic: CRITTS

Radiographic features

Plain radiograph

Chest radiographic findings can be normal or, if abnormal, non-specific. Some associated features include:

hyperinflation
attenuation of vascular markings
occasionally reticular/reticulonodular markings

CT

On HRCT chest, there are often sharply defined, areas of decreased lung attenuation associated with vessels of reduced caliber. These changes represent a combination of air trapping and oligemia. This combination can give a mosaic attenuation pattern. Other features include: