PURPOSE: Bronchiolitis Obliterans Organizing Pneumonia (BOOP) is a distinct entity that remains relatively uncommon. The goal of this study is to review the epidemiology, the clinical features, the radiographic manifestations and the methods of diagnosis of BOOP.
METHODS: We retrospectively studied 20 patients of biopsy-proven bronchiolitis obliterans organizing pneumonia (BOOP) reported between September 1994 and August 1995. Patient’s informations were extracted from the medical charts. The study protocol was approved by the Institutional Review Board at Albert Einstein Medical Center.
RESULTS: There was no sex predilection, women and men were affected equally 9/11 (45%/55%), the mean age was 59.6 [25-81], more than half of the patients were African-Americans. None of the patients were exposed to inhaled toxins, there was no clinical evidence of any collagen disease at initial presentation and among patients with history of malignancy, 3/4 (75%) had recent or prior history of lymphoma. Most of our patients presented with dyspnea and dry cough and half of them with fever. The median duration of symptoms was 30 days. Almost half of the patients were treated for presumed community acquired pneumonia. The other half had persistent pulmonary infiltrates suspicious for malignancy. There was a wide spectrum of roentgenographic patterns, ranging from focal consolidation to bilateral mixed alveolar interstitial disease. Pleural effusion was noted only in three patients. Out of 12 initial transbronchial biopsies, 7 (58%) were not diagnostic and were followed by either video-assisted thoracic surgery or open lung biopsy. In two patients, the diagnosis was made at autopsy.
CONCLUSION: In our study, most of the patients presented with dyspnea and dry cough. The median duration of symptoms was 30 days. Almost half of the patients were treated for presumed pneumonia whereas the other half had persistent pulmonary infiltrates suspicious for malignancy. Definitive diagnosis was made mainly by VATS or OLB.
CLINICAL IMPLICATIONS: The clinician can very well suspect bronchiolitis obliterans organizing pneumonia (BOOP) on the basis of patient’s history, unresolving pneumonia or persistence of an unusual radiograph.
DISCLOSURE: Hakim Ali, None.