BOOP and clear chest X-rays

I was diagnosed with Boop back in Nov., have been on high dose steroids since. I am progressing slowly, lung function is up from 40% to 57%, but my x-rays have not cleared at all. Is this normal? My doc says it's no big deal if my x-rays are never clear.

[National Jewish Health]

The most important information, above, is that bronchiolitis obliterans with organizing pneumonia (BOOP) usually responds rapidly and completely to corticosteroids, in the majority of cases.  This resolution most often occurs when the diagnosis is made and therapy begun, in the early stages of the disease.  The response is not nearly as satisfactory in the chronic stages of the disease.  X-ray resolution is important but pulmonary function is, if anything, more important and will correlate to some degree with the intensity of the pulmonary infiltrates.

The slow response to therapy that you have experienced is atypical for BOOP and may be a reason to question the diagnosis, especially if the diagnosis of BOOP was made without a biopsy.  You should discuss this with your doctor, along with the question of whether therapy with cyclophosphamide might be worthy of consideration.