PMC7152670_01
Chest images of the patient at initial presentation.. No significant findings were seen on chest inspiration CT (A), whereas expiration CT displayed a mosaic pattern in the upper lobe and air trapping in the lower lobe (B).
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No significant findings were displayed on chest x-ray or inspiration CT, whereas expiration CT displayed a mosaic pattern in the upper lobe and air trapping in the lower lobe (Fig. 1A and B).
Histopathological analysis of lung biopsy specimens.. High stenosis was observed in the bronchiolar lumen by Hematoxylin Eosin staining (A, B), and fibrous stenosis owing to bronchiolar elastic fiber and collagen fiber proliferation was observed by EVG staining (C). Magnification:x40, x 400.
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Histopathological analysis of surgical lung biopsy tissue showed extensive stenosis of the bronchiolar lumen, and fibrous stenosis owing to bronchiolar elastic fiber and collagen fiber proliferation by EVG staining (Fig. 2), and the patient was diagnosed as having OB.
Treatment course of the patient.. The patient initially started beta-stimulant treatment for her dyspnea. Three months after onset, she additionally started LAMA and ICS because her forced expiratory volume in 1 second (FEV1.0) decreased markedly and her dyspnea deteriorated. Imatinib was discontinued 12 days after the onset of OB and her treatment was changed to interferon-alpha, and subsequently to nilotinib at the time of recurrence; however, deterioration of FEV1.0 was not observed in the subsequent 10 years.
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However, even after changing to nilotinib, her FEV1.0 and dyspnea did not worsen (Fig. 3).