Rare Manifestation of Idiopathic Tracheobronchopathia Osteochondroplastica: Misdiagnosed and Untreated Entity? (original) (raw)
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Tracheobronchopathia Osteochondroplastica - A rare or an overlooked entity?
Journal of Radiology Case Reports, 2013
Tracheobronchopathia osteochondroplastica is an idiopathic non-malignant disease of large airways featured by submucosal cartilaginous to osseous nodules overlying the cartilaginous rings, which may be focal or diffuse. Clinical presentation varies from asymptomatic to symptoms like breathlessness, recurrent chest infections, cough and hemoptysis. Due to the lack of awareness of this disease, it remains an under recognized entity. We are describing the computed tomography and bronchoscopic findings of two recently diagnosed cases at our institute. The purpose of this report is to familiarize radiologists with imaging appearance of this condition, with the goal of increasing clinical suspicion of this uncommon condition.
Multidisciplinary Respiratory Medicine, 2016
Background: Tracheobronchopathia Osteochondroplastica (TBPO) is an uncommon and benign condition characterized by osseous or metaplastic cartilaginous 1-3 mm nodules in the submucosa of the tracheobronchial tree. Posterior membranous wall of trachea is typically spared. Ecchondrosis and exostosis nodules can cause chronic inflammation and mucosal metaplasia, stiffness and airway obstruction. The prevalence of this disease, often asymptomatic or associated with nonspecific symptoms, is underestimated, and the mean age at diagnosis is 50 years. Case presentation: We report a case of a 49 year old male, non-smoker. He was a smith, homeless, born in Romania and reported a diagnosis of asthma since childhood. He was admitted to our Respiratory Unit presenting low-grade fever with profuse sweating, cough, purulent sputum, and ground-glass opacity with irregularity in main bronchi detected by High-Resolution Computed Tomography (HRCT) scan. Fibrobronchoscopy revealed the presence of mucosal irregularities up to the segmental bronchi entrance. Histological examination showed nodules of osseouscartilaginous nature, consistent with TBPO. Microbiological tests of Bronchoalveolar Lavage fluid also revealed an infection by Pseudomonas Aeruginosa. Conclusion: TBPO is a rare disease characterized by wheezing, cough, hemoptysis, and recurrent pulmonary infections, with typical onset during adulthood. In the case reported, the symptoms began in childhood, although they had been misinterpreted as asthma. Even if childhood-onset is not reported in literature, it is likely that small changes occur in the first few years of life and become more evident in adulthood. The involvement of segmental and sub-segmental bronchi, usually spared in TBPO, could explain the presence of wheezing and non-productive cough reported by our patient since childhood.
Tracheobronchopathia Osteochondroplastica - Case Report
2005
Tracheobronchopathia osteochondroplastica (TO) is a rare and usually benign disorder affecting the trachea and occasionally the bronchi. The authors described a case of 42−year−old man who was diagnosed to have TO by chance because of difficult intubation preceding cholecystectomy. Fiberoptic bronchoscopy revealed a characteris− tic picture of TO: multiple whitish, irregularly shaped nodules in the walls of the trachea and the main right bronchus excepts in the pars membranacea. CT−scan revealed a moderate narrowing of the trachea with a irregu− larity of the walls related to the presence of nodules containing calcium deposits. Despite macroscopic changes lung function tests were within normal limits. The histological examination confirmed the diagnosis of TO and the immunocytochemical analysis of a dysplastic epithelium did not reveal the overexpression of cancer molecular markers. The case presented here demonstrates that even progressive TO may remain asymptomatic (Adv Clin Exp M...
Coexistence of tracheobronchopathia osteochondroplastica and lung cancer: a case report
Turkish Journal of Thoracic and Cardiovascular Surgery, 2014
Trakeobronkopatia osteokondroplastika (TO) trakea lümenine doğru uzanım gösteren kemik veya kıkırdak dokusu ile karakterize nadir bir hastalıktır. Bu makalede adenokarsinomun eşlik ettiği bir TO olgusu sunuldu. Elli altı yaşındaki erkek hastanın kronik öksürük ve kanlı balgam tükürme yakınmaları vardı. Akciğer filminde sağ hilusun üst tarafından başlayan ve lateral kısma doğru genişleyen homojen opasite izlendi. Toraks bilgisayarlı tomografi ve bronkoskopi yapıldı. Örneklenen trakeal lezyonlar TO olarak, sağ üst lobun ön segmentindeki lezyon ise adenokarsinom olarak bildirildi. Anah tar söz cük ler: Adenokarsinom; bronkoskopi; öksürük; hemoptizi; osteokondrodisplazi. Tracheobronchopathia osteochondroplastica (TO) is a rare disorder characterized by the projection of numerous bony or cartilaginous spurs into the tracheal lumen. This article reports a case in whom TO was detected accompanied by adenocarcinoma. A 56-year-old male presented with complaints of chronic cough and bloody sputum. Chest X-ray showed homogeneous opacity starting from the upper part of right hilus and extending to the lateral part. Thoracic computed tomography and bronchoscopy were performed. Tracheal lesion specimens were reported as TO and the lesion in the anterior segment of the right upper lobe was reported as adenocarcinoma.
Tracheobronchopathia Osteochondroplastica as a Single Mass in Lingular Bronchus
The Annals of Thoracic Surgery, 2018
We describe a rare case of tracheobronchopathia osteochondroplastica (TBO) in a 35-year-old man who presented with recurrent chest infection and hemoptysis. Bronchoscopy and computed tomography scan revealed a single 1.5-cm hard nodular mass lesion in the lingular bronchus associated with collapse and bronchiectasis of the lingula. The patient underwent open left lingulectomy with removal of the mass. Histopathology of the lesion showed characteristic features of TBO. TBO is generally characterized by multiple nodules in the trachea or main bronchi. The presentation of TBO as a single dominant mass is rare and can be considered as a differential diagnosis for intrabronchial calcified mass lesions.
Osteochondroplastic Tracheobronchopathy: Report of Two Cases
CHEST Journal, 2014
INTRODUCTION: Osteochondroplastic tracheobronchopathy (OT) is a rare benign disorder, with unknown etiology, characterised by the presence of osteocartilaginous nodules within the submucosa of the anterior and lateral walls of the trachea and the main bronchus. CASE PRESENTATION: Case report 1: 70 year-old male, past smoker, with a history of pulmonary tuberculosis, was sent to Pulmonology for a lung nodule observed in a chest x-ray. He complained of occasional cough and uncharacteristic left thoracic pain. The chest-CT revealed lung micronodules, the biggest with 8.6 mm, diffuse bronchiectasis and small irregular nodularities, with tracheobronchial lumen projection. The patient was submitted to a bronchofibroscopy, where nodular deformities in the anterior and lateral walls of the trachea were observed and biopsied. The histological examination confirmed the diagnosis of OT. No specify therapy was initiated and the patient maintained follow-up. Now, 2 years after the diagnosis, he is asymptomatic and with radiological stabilization of the lesions. Case report 2: 70 year-old male, admitted to the hospital for a left pleural effusion, which was interpreted as metapneumonic and treated with antibiotherapy for 17 days. The chest-CT revealed a left pleural effusion and calcified nodular irregularities in the lower portion of the anterior wall of the trachea. After hospital discharge, the result of blood cultures were obtained, which were positive for Mycobacterium Tuberculosis (MT),
Tracheobronchopatia osteochondroplastica case resulting with big airway obstruction
Journal of Experimental & Clinical Medicine, 2019
Tracheobronchopatia osteochondroplastica(TO) is a very rare non neoplastic tracheobronchial disorder with an unknown etiology.It's characterized by bony or cartilaginous( or both) milimetric nodules in the submucosa of trachea and bronchial walls.In this case,a 50 year old man identified with a big airway obstruction in respiratory function test and bronchoscopy and diagnosed as TO after cured with right middle lobectomy is presented with the literature data.
The Annals of Thoracic Surgery, 2005
with presentation on a chest radiograph followed by CT evaluation, an indeterminate needle biopsy, and eventually an operative diagnosis. The CT findings of a pleuralbased mass are nonspecific and several other etiologies are possible including mesothelioma, schwannoma, lymphoma, and metastatic disease [2-4]. With such other pathologies in the differential diagnosis, a tissue sample seems warranted using either a needle or thoracoscopic incisional biopsy. Intrathoracic splenosis may be diagnosed on the basis of a technetium 99m Tc-labeled heat-damaged erythrocyte scan, 99m Tc sulfur colloid scintigraphy, or indium 111 In-labeled platelet scan [2, 5]. The postoperative examination of the peripheral blood smear revealed the presence of Howell-Jolly bodies-evidence that the ectopic splenic tissue is nonfunctional. Howell-Jolly bodies represent nuclear material within the erythrocyte and are normally retained by a functional spleen. Preoperative diagnosis of intrathoracic splenosis should be considered in any patient who presents with left-sided pulmonary nodules and a history of thoracoabdominal trauma, particularly if the patient underwent a splenectomy. Most authors agree that intrathoracic splenosis is a benign process and may even provide a protective role.