J Korean Med Sci. 2002 Apr;17(2):179-186. English.
Published online Apr 24, 2009.
Copyright © 2002 The Korean Academy of Medical Sciences
Original Article

Bronchiolitis Obliterans Organizing Pneumonia:Clinicopathologic Review of a Series of 45 Korean Patients Including Rapidly Progressive form

Joon Chang, Joungho Han, Dong Won Kim, Inchul Lee, Kyo Young Lee, Soonhee Jung, Hye Seung Han, Bong Kwon Chun, Seong Jin Cho, Kibeom Lee, Beom Jin Lim and Dong Hwan Shin
    • Department of Internal Medicine, Yonsei University, Seoul, Korea.
    • Department of Pathology, Yonsei University, Seoul, Korea.
    • Departments of Pathology, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Korea.
    • Soonchunhyang University, Seoul, Korea.
    • Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
    • Catholic University of Korea, Seoul, Korea.
    • Wonju Medical College, Yonsei University, Wonju, Korea.
    • Inha University, Inchon, Korea.
    • Kosin University, Busan, Korea.
    • Korea University, Seoul, Korea.
    • Ajou University, Suwon, Korea.

Abstract

Bronchiolitis obliterans organizing pneumonia (BOOP) is a clinicopathological syndrome associated with a variety of disease entities. The aim of this study was to review cases with initial diagnosis of BOOP applying uniform histopathologic criteria, and analyze the clinical characteristics of proven cases of BOOP including rapidly progressive form. A total of 81 cases, initially diagnosed as BOOP and with available tissue sections, was collected. Thirty six cases (44.4%) were excluded from the study, more than two thirds of which were given a revised diagnosis of interstitial pneumonitis/fibrosis other than BOOP. Thirty one patients were classified as idiopathic BOOP, 8 patients as secondary BOOP, and 6 patients as rapidly progressive BOOP. Open lung biopsy specimen from all six cases with lethal outcome showed more severe interstitial inflammation and septal fibrosis and/or alveolar exudate with a varying degree than those with good prognosis. There was no difference by the sexes. The two most frequent presenting symptoms were cough and dyspnea. Bilateral multifocal consolidation was a common radiological finding. More than 70% cases of idiopathic BOOP experienced clinical improvements. The diagnosis of BOOP is usually suggested by clinicoradiologic findings, but needs to be confirmed histopathologically, preferably through surgical open or video-assisted thoracoscopic biopsy.

Keywords
Bronchiolitis Obliterans Organizing Pneumonia; Retrospective Studies; Pathology


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