Tracheobronchopathia osteochondroplastica: a case report and literature review

Abstract

Tracheobronchopathia osteochondroplastica (TO) was diagnosed in a 52-year-old male with prolonged dry cough. Computerized tomography (CT) demonstrated that there were multiple calcified nodules in the anterolateral wall of trachea, sparing the posterior tracheal membrane. Fiberoptic bronchoscopy (FOB) showed that submucosal nodules protruded into the airway lumen. Histopathological exam found ossification and cartilage in the submucosa. TO is a scarce benign disorder, characterized by submucosal bony and cartilaginous nodules. The clinical manifestation is undistinguished and treatment is symptomatically dependent. FOB is a definitive diagnostic procedure. The characteristics of FOB finding are described as beaded, spiculate, rock garden, or cobble-stoned like nodules, which projected into the tracheobronchus lumen, sparing the posterior wall. Histopathological exam might re-confirm the diagnosis, finding ossification and cartilage in the submucosa of airway. Awareness of TO is significantly important, especially in chronic cough patients with special CT image, and FOB should be performed to confirm the diagnosis.

Keywords: Tracheobronchopathia osteochondroplastica (TO); cough; fiberoptic bronchoscopy (FOB).

Figure 1

CT scan showed of calcified nodules from tracheal wall into the air lumen.

Figure 2

FOB demonstrated that multiple nodules from anterolateral wall of trachea and main bronchi protruded into the lumen.

Figure 3

Histopathological exam from the biopsy illustrated of submucosal ossification and cartilage formation.