Pediatric Bronchiolitis Obliterans

Etiology: Bronchiolar inflammation with submucosal peribronchial fibrosis that often is seen post-viral
Imaging CXR:
— Bronchial dilation
— Hyperinflation
— Reticulonodular infiltrates
Imaging CT:
— Reversed atoll sign suggests bronchiolitis obliterans with organizing pneumonia but is not specific
DDX:
Complications:
Treatment:
Clinical:

Radiology Cases of Bronchiolitis Obliterans

CXR and bronchogram of bronchiolitis obliterans — CXR (above) shows chronic interstitial infiltrates in both lungs. Bronchograms of both lungs (below) shows airway dilation, left greater than right.

CXR and CT of bronchiolitis obliterans — 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).

Radiology Cases of Bronchiolitis Obliterans With Organizing Pneumonia

CXR and CT of bronchiolitis obliterans with organizing pneumonia — CXR (above) shows bilateral basilar infiltrates and blunting of the left costophrenic angle. Axial CT without contrast of the lung (below) shows bilateral lower lobe bronchiectasis and mild interstitial prominence, the upper lobes appeared normal.