Noninfectious Pulmonary Manifestation of GVHD: Bronchiolitis Obliterans Syndrome

  • Cecilia C. S. YeungEmail author
  • Sahl Ali
  • Howard M. Shulman


Pulmonary manifestations of GVHD encompass a spectrum of histologic lesions associated with both acute GVHD (aGVHD) and chronic GVHD (cGVHD). These include cryptogenic organizing pneumonia (COP), multifactorial lymphocytic bronchiolitis (LLB), and constrictive bronchiolitis obliterans (CBO). Workup of patients suspected of pulmonary cGVHD should include radiologic studies such as CT, pulmonary function tests, and bronchoalveolar lavage to rule out potential infectious agents. Lung biopsy to diagnose constrictive bronchiolitis obliterans is indicated when no other sites of involvement by cGVHD are discovered. Here we present a patient with complex pathology post-HSCT with histologic features in a lung biopsy of cryptogenic organizing pneumonia (formerly termed bronchiolitis organizing pneumonia (BOOP)) and necropsy changes of acute bronchopneumonia admixed with features of both organizing pneumonia and constrictive bronchiolitis.


GVHD Pulmonary function tests (PFT) Bronchiolitis obliterans syndrome (BOS) Constrictive bronchiolitis obliterans (CBO) Lymphocytic bronchiolitis (LLB) Cryptogenic organizing pneumonia (COP) 


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Cecilia C. S. Yeung
    • 1
    • 2
    • 3
    Email author
  • Sahl Ali
    • 3
  • Howard M. Shulman
    • 1
    • 2
    • 3
  1. 1.Clinical Research DivisionFred Hutchinson Cancer Research CenterSeattleUSA
  2. 2.Department of PathologyUniversity of Washington School of MedicineSeattleUSA
  3. 3.Pathology SectionSeattle Cancer Care AllianceSeattleUSA

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