An inflammatory disorder involving both the peripheral bronchioles and alveoli simultaneously. It has distinctive radiographic findings, histologic features, and response to corticosteroids (unlike usual interstitial pneumonia).
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Most common type is idiopathic BOOP; other types include focal nodular, postinfection, drug-related, rheumatologic, immunologic, organ transplantation, radiation therapy, environmental, and miscellaneous BOOP.
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Accounts for 20% to 30% of all cases of chronic infiltrative lung diseases. It occurs equally among men and women, and is not related to smoking.
High-resolution chest computed tomography scan shows bilateral patchy triangular ground-glass opacities with air bronchograms usually located peripherally.
Lung biopsy may be required to establish the definitive diagnosis in patients with unusual findings or severe disease.
Idiopathic BOOP is treated with corticosteroids.
Cases with an underlying cause (e.g., drug-related BOOP) should have the causative factor removed; corticosteroid therapy is indicated in some cases.
Also found in: Acronyms.
BOOP
BOOP
Bronchiolitis obliterans organising pneumonia. A disease once considered a form of interstitial pneumonia.Aetiology
Prior infectious bronchiolitis; toxic inhalants; as part of various disease processes, including hypersensitivity pneumonitis (extrinsic allergic alveolitis), collagen vascular disease and drug hypersensitivity; the nonspecific nature of the BOOP reaction makes this diagnosis difficult.
Clinical findings
Cough, dyspnoea, “flu” symptoms; 50% recover, 12% eventually die of disease, many develop usual interstitial pneumonia; obstructive symptoms are limited to smokers, most of whom have restrictive disease and impaired diffusing capacity; remission may follow corticosteroid therapy.
DiffDx
Organisation in infections, pneumonias associated with other conditions—e.g., COPD, cystic fibrosis, bronchiectasis, distal obstruction, aspiration diffuse alveolar damage, eosinophilic pneumonia, collagen vascular disease—allergic reactions (e.g., extrinsic allergic alveolitis, vasculitis) and reactive to other processes (abscesses, infarcts, tumours).
Imaging
Patchy ground-glass appearance on AP chest film.
BOOP
Bronchiolitis obliterans organizing pneumonia A disease once considered a form of interstitial pneumonia Etiology Obscure; ? associated with toxic fumes, infection, connective tissue disease Clinical Cough, dyspnea, 'flu' symptoms, 50% recovery, 12% BOOPs eventually die of disease, many develop usual interstitial pneumonia; obstructive symptoms are limited to smokers, most of whom have restrictive disease and impaired diffusing capacity, remission may follow use of corticosteroids Radiology Patchy ground-glass appearance on AP chest film DiffDx Organization in infections, pneumonias associated with other conditions–eg COPD, cystic fibrosis, bronchiectasis, distal obstruction, aspiration diffuse alveolar damage, eosinophilic pneumonia, collagen vascular disease, allergic reactions–eg extrinsic allergic alveolitis, vasculitis, and reactive to other processes–abscesses, infarcts, tumorsBOOP
Boop Lung Disease
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