Bronchiolitis obliterans and organizing pneumonia (BOOP) is a syndrome that has been associated with a variety of underlying disorders, including infection, collagen vascular diseases and toxic fume inhalation. Rarely, however, BOOP has been associated with radiation- or chemotherapy-induced pulmonary toxicity. Over the past 3 years, several case series have reported BOOP in the unique setting of radiation in breast cancer patients. This study describes our experience with this newly recognized syndrome and a review of the English-language literature on this syndrome.

The extent to which a single breath measurement represents available gas dilutional as well as compressible thoracic volume in emphysema patients has not been quantified. We therefore measured single breath (TLC SB ) and rebreathe helium dilution (TLC RB ), and plethysmographic lung volume (TLC pleth ), in fifty-five outpatients with clinical and radiographic emphysema, and in twenty-one normal controls. Among emphysema patients, TLC SB increasingly underestimated both TLC pleth and TLC RB as FEV 1 % predicted decreased (p for interaction = 0.001 for both) by a mean of 1.7 liters for TLC RB (p < 0.001) and 2.2 liters for TLC pleth (p < 0.001). In contrast, TLC RB underestimated TLC pleth by a mean of 0.5 liters (p < 0.001) regardless of FEV1% (p for interaction = 0.25). TLC SB , TLC RB , and TLC pleth showed strong agreement among normal subjects. We conclude that TLC SB underestimates available gas dilutional and compressible lung volume as physiologic emphysema severity increases. In contrast, TLC RB and TLC pleth show closer agreement which is unaffected by physiologic emphysema severity.

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