CTICasesChronic Lung Allograft Dysfunction with Pleuroparenchymal Fibroelastosis and Bronchiolitis Obliterans
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Imaging findings
Radiographs demonstrate hyperinflation and new opacities in the upper lung zones. CT confirms apical lung scarring with relatively opaque upper lobes compared to the lower lung zones. These findings are consistent with plural parenchymal fibroelastosis (PPFE) and bronchiolitis obliterans, often seen together in chronic lung allograft dysfunction.
Key takeaways
Chronic lung allograft dysfunction can present as a combination of restrictive lung disease (often due to pleuroparenchymal fibroelastosis) and obstructive lung disease (bronchiolitis obliterans), especially in long-term survivors of lung transplantation. PPFE can also be seen in hematopoietic stem cell transplantation. Voriconazole therapy can cause hyperostosis, which should be recognized as a treatment-related side effect.
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