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Severe Constrictive Bronchiolitis Obliterans

Imaging findings

Chest CT shows severe hyperinflation and diaphragmatic flattening with visible costal attachments. Expiratory CT shows near-complete absence of volume change, with no movement of the posterior tracheal membrane. PFTs show severe airway obstruction without an expiratory plateau.

Key takeaways

Severe constrictive bronchiolitis obliterans causes fixed airway obstruction and severe air trapping. This can be recognized on expiratory CT by the lack of lung volume reduction and the absence of normal tracheal wall collapse.

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