C.P.C. : The 775th Clinicopathological Conference : A Case of Clinically Diagnosed Bronchiolitis Obliterans Complicated by Pulmonary Aspergillosis

[ABSTRACT] We report on a woman in her early 60s with follicular lymphoma in whom a severe obstructive ventilatory defect developed and was clinically attributed to bronchiolitis obliterans. The patient was treated with macrolide antibiotics, inhaled corticosteroids, and bronchodilators but responded only moderately. She was treated with steroid pulse therapy and nintedanib but showed no clinical response. The patient eventually died of pulmonary aspergillosis. The autopsy showed evidence of only infectious disease. Bronchiolitis obliterans is difficult to diagnose and refractory to treatment. Physicians should be aware of the disease entity for early diagnosis and careful treatment because "treatment" can result in significant harm.