Bronchiolitis obliterans after bone marrow transplantation: evaluation with lung scintigraphy.

Bronchiolitis obliterans (BO) has been described as a main pulmonary complication following allogeneic bone marrow transplantation (BMT). Diagnosis of BO is usually based on clinical findings, pulmonary function tests, and computed tomography scan. However, histological examination of an open-lung biopsy specimen may sometimes be necessary to confirm the diagnosis, despite its relative invasiveness. The ventilation lung scan is another useful but non-invasive diagnostic method. In this study, we present two post-transplant BO cases, each showing different clinical conditions, characterized by delayed wash-out on 133Xe gas and airway depositions on radioaerosol inhalation scans. These methods succeeded in revealing pulmonary obstruction in cases where the pulmonary function tests were within normal range and the high-resolution CT scans (HR-CT) of the chest were only minimally abnormal, suggesting their usefulness as an additional tool in the diagnosis of post-transplant BO, as well as in the follow-up to pulmonary obstruction.