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Case Reports
. 2020 Jul;19(3):267-271.

Diagnosis and Treatment Process of Tracheobronchopathia Osteochondroplastica with Concurrent Chronic Eosinophilic Pneumonia: a Case Report

Rama Bozorgmehr  1 , Besharat Rahimi  2
Affiliations
Case Reports

Diagnosis and Treatment Process of Tracheobronchopathia Osteochondroplastica with Concurrent Chronic Eosinophilic Pneumonia: a Case Report

Rama Bozorgmehr et al. Tanaffos. 2020 Jul.

Abstract

Background: Tracheobronchopathia Osteochondroplastica (TBPO) is a rare disease with a benign period affecting the bronchial system. It is characterized by the presence of numerous osseous submucosal nodules or cartilaginous protruding into the tracheobronchial lumen. These wounds are diagnosed incidentally during bronchoscopy. We reported the stages of diagnosis and treatment of a 46-year-old patient with TBPO and concurrent chronic eosinophilic pneumonia.

Case presentation: A 46-year-old non-smoking Afghan male exposed to adhesives and chemicals in Iran for more than 25 years was admitted to a pulmonary ward with symptoms of exertional dyspnea, dry coughing, occasional nocturnal sweating for 6 years, tachycardia, hypoxia, and generalized wheezing during expiration. A symbicort inhaler and Montelukast pills were prescribed for him with the probable diagnosis of asthma. High-resolution computed tomography (HRCT) was performed on the patient and the results showed non-significant multiple lymph nodes with maximum diameters (SAD = 7 mm). HRCT also showed that the patient had protuberances on the trachea surface and thus underwent bronchoscopy for further examination. The results indicated numerous protuberances of white cartilage from the proximal part of the trachea to the distal part without the involvement of the posterior membrane. The biopsy result confirmed TBPO. Prednisolone was prescribed for the patient to treat the chronic eosinophilic pneumonia. However, we had to continue the daily dose of 5mg prednisolone due to the recurrence of the symptoms.

Conclusion: The lack of response to a bronchodilator in a patient suspicious to asthma must make us think about other causes of respiratory wheezing such as TBPO.

Keywords: Diagnosis; Eosinophilic Pneumonia; Tracheobronchopathia Osteochondroplastica.

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Conflict of interest statement

Conflict of interest The authors declare that there is no conflict of interest in this study.

Figures

Figure 1.
Figure 1.
Chest X-ray of the patient in the first referral to Emergency department
Figure 2.
Figure 2.
First CT scan cuts
Figure 3.
Figure 3.
Protuberances of white cartilage with an inflamed appearance in bronchoscopy
Figure 4.
Figure 4.
Biopsy of the tracheal protuberances
Figure 5.
Figure 5.
Patients CT scan in Follow up
See this image and copyright information in PMC

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