Tracheobronchopathia osteochondroplastica: Case report and literature review

Abstract

Tracheobronchopathia osteochondroplastica (TPO) is a rare disorder characterized as multiple osseous or cartilaginous nodules in the submucosa of trachea and main bronchi. TPO remains an under recognized entity due to lack of awareness. Four cases of TPO are reported in this review as well as various facets of TPO description.

Keywords: Ossification; Tracheal disease; Tracheal stenosis; Tracheobronchopathia osteochondroplastica.

Fig. 1

Chest CT showing the tracheal morphology of the scabbard, irregular thickening and calcified nodules that protruding into the tracheobronchial lumen. Nodules arise from the anterior and lateral aspect of the inner tracheal wall. And the nodules arose from cartilage, posterior membranous wall of trachea is typically spared.

Fig. 2

Bronchoscopy showed widespread mucosal protuberances looking like pearl drops in the distal lateral and anterior walls of trachea. These nodules have “rock garden” or “cobblestone” appearance. Partly conglomerated and swollen mucosal lesions in the right main bronchus reaching to the upper lobe bronchus and similar lesions in the left main bronchus were detected. These nodules are hard on touch and gives gritty sensation while passing the scope through the lumen.

Fig. 3

Histopathological examination showed pseudostratified ciliated columnar epithelium mucosa of chronic inflammation with hemorrhage; epithelium was squamous metaplasia, hyperplasia and hyperkeratosis, submucosa cartilage osseous metaplasia, see lots of keratinized material with calcification.