Constrictive bronchiolitis

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Constrictive bronchiolitis is rare medical lung disease. It is also known as bronchiolitis obliterans, obliterative broncholitis,[1] and bronchiolitis obliterans syndrome (abbreviated BOS).[2]

It should not be confused with idiopathic bronchiolitis obliterans organizing pneumonia (BOOP), and old term for cryptogenic organizing pneumonia.


  • Not the same as (idiopathic) bronchiolitis obliterans organizing pneumonia (BOOP) - in short:
    • BOOP: clogs the airway, has Masson bodies, treated with steroids - good prognosis.
    • Constrictive bronchiolitis: fibrosis around airways, crappy prognosis.
  • No good treatment.
  • Progressive.



  • Hyperlucent lung (due to air trapping).



  1. Bronchiolitis - mononuclear and neutrophilic.
    • May be minimal late in the disease.
  2. Fibrosis - submucosal and peribronchiolar.
    • Can be patchy.


  • Bronchioles = noncartilagenous airways usu. < 2 mm in diameter.[1]
  • May be patchy.
  • Diagnosis should be considered if the airway is smaller than the accompanying artery.



  • Elastic trichrome - useful for delineation of obliterated bronchioles.

See also


  1. 1.0 1.1 1.2 1.3 1.4 Visscher, DW.; Myers, JL. (2006). "Bronchiolitis: the pathologist's perspective.". Proc Am Thorac Soc 3 (1): 41-7. doi:10.1513/pats.200512-124JH. PMID 16493150.
  2. Sato, M.; Keshavjee, S. (2008). "Bronchiolitis obliterans syndrome: alloimmune-dependent and -independent injury with aberrant tissue remodeling.". Semin Thorac Cardiovasc Surg 20 (2): 173-82. doi:10.1053/j.semtcvs.2008.05.002. PMID 18707652.
  3. 3.0 3.1 Chien, JW.; Duncan, S.; Williams, KM.; Pavletic, SZ. (Jan 2010). "Bronchiolitis obliterans syndrome after allogeneic hematopoietic stem cell transplantation-an increasingly recognized manifestation of chronic graft-versus-host disease.". Biol Blood Marrow Transplant 16 (1 Suppl): S106-14. doi:10.1016/j.bbmt.2009.11.002. PMID 19896545.