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Severe Sporadic Constrictive Bronchiolitis

Imaging findings

High-resolution CT chest shows diffuse mosaic perfusion with severe, geographic air trapping on expiratory scans, without signs of bronchiectasis or interstitial fibrosis, in a patient with progressive dyspnea and no history of connective tissue disease or toxic inhalation.

Key takeaways

Sporadic constrictive bronchiolitis is a rare, idiopathic form of small airway disease characterized by fibrotic narrowing of the membranous bronchioles. Expiratoy CT is the imaging gold standard to demonstrate diagnostic air trapping, which correlates with fixed airflow obstruction on pulmonary function tests.

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