Pathologic Aspects of Bronchiolitis Obliterans Organizing Pneumonia

Abstract

e term “bronchiolitis obliterans organizing pneumonia (BOOR)” is a relatively recent term for a cinicopathologic entity that has been recognized for some time.’ The name derives from a series of cases collected in the 1970s and 1980s by Charles Carnington. These represented exasnples of idiopathic diffuse (or at least multifocal) interstitial pneumonia clinically that showed histologic features of bronchiolitis obliterans with patchy organizing pneumonia, as well as other features as discussed below. This series was collected and collated by Epler et al’ and published in the New England Journal of Medicine as “bronchiolitis obliterans organizing pneumonia.” The eponym BOOR derives from histologic presence of bronchiolitis obliterans and organizing pneumonia. BOOR is not a new lesion and similar cases have been previously reported under a number of different synonyms CFable 1).’� Some of the previous synonyms for BOOR have emphasized the presence of bronchiolitis obliterans because of its identification histologically�’� and not on the basis of clinical evidence of airflow obstruction. Lange7 is credited with the first histologic description of bronchiolitis obliterans in an autopsy study of 2 patients, 1 of whom died of an acute illness in 8 days, and the other who died after 6 months of progressive lung disease. Microscopically, polypoid granulation tissue was found in airways and the terms “bronchitis and bronchiolitis obliterans” were applied.� Subsequent to this report, bronchiolitis obliterans is mentioned as a histologic finding in a number of other studies, notably those of Winternitz’ in 1920 on war gas inhalation and the 1918 influenza pandemic,’ Blumgart and MacMahonbo in 1929, McAdams” in 1955, and Gosink ------�-----� �-�----�