Pneumothorax complicating fatal bronchiolitis obliterans organizing pneumonia

Bronchiolitis obliterans organizing pneumonia (BOOP) is an uncommon pulmona ry disorder, the clinical spectrum of which is variable. We present a fatal case of BOOP, which developed spontaneous pneumothorax, a complication con sidered rare. Unusual was also the upper lobe distribution of the infiltrat es. the histologically diagnosed disease failed to respond to antibiotics a nd corticosteroids and the 74-year-old patient eventually succumbed with ac ute respiratory distress syndrome, 50 days after disease onset. Spontaneous pneumothorax should be added to the complications of BOOP, which may adver sely affect prognosis.