Multi-nodule of large airway: tracheobronchopathia osteochondroplastica

Abstract

Background: Tracheobronchopathia osteochondroplastica (TO) is a benign rare disease characterized by multiple tracheobronchial nodules, which has not been clearly illuminated and there are no standard guidelines for TO management. The aim of this study was to clarify the clinical features and treatment outcomes of TO and provide basis for clinical diagnosis and treatment.Methods: A total of 32,215 patients taken bronchoscopy were retrospectively reviewed to select patients diagnosed with TO. Clinical characteristics, bronchoscopic manifestations, CT images, histopathological features, treatments and clinical course were investigated.Results: 13 males and 6 females were identified as TO. The average age was 47.42±12.12 years. The incidence rate of TO in our study by bronchoscopy was 0.06%. The most frequent manifestation was chronic cough. Based on bronchoscopic manifestations, patients were categorized as three groups: the largest proportion was group of Stage II (10/19), followed by stage III (5/19) and stage I (4/19). The positive rate of CT in stage I, stage II and stage III was 0%, 50%, 100%, respectively. Histopathological analysis presented inflammatory exudation, squamous metaplasia, submucosal cartilaginous and osseous deposition.Bronchoscopic intervention and inhaled corticosteroids were administered to subjects in stage II and III, which improved their life qualities to some degree.Conclusions: Not only multi-disciplinary cooperation of clinical, endoscopic and histological assessment, but also awareness are crucial to TO diagnosis, especially in early stage of TO, which was difficult to identify.The stage of TO based on bronchoscopic visualization might be applied to guide the choice of clinical treatment strategy.

Tracheobronchopathia Osteochondroplastica – to Biopsy or not to Biopsy? A Relook at The Rare Disease

“…Bronchoscopy is considered the gold standard for diagnosis, 15 and the typical findings range from a cobblestone appearance to stalactite cave or rock garden appearance 16 (Fig. 2A, B).…”

Endobronchial Lipoma: A Rare Cause of Bronchial Stenosis or Obstruction

“…Given that adipose tissues are often present outside the cartilage ring of large bronchi, it is noteworthy that the vast majority of endobronchial lipomas tend to occur in the central airway [ 14 ]. The distinctive low density of lipomas, in contrast to other tumors [ 15 ] or inflammatory conditions, is helpful for an initial differential diagnosis. The locations and sizes of these masses could determine whether the airway patency has been compromised.…”

Multi-Nodule of Large Airway: Tracheobronchopathia Osteochondroplastica, Two Cases Report and Literature Review

“…4 The current incidence rate ranges from 1:400 (.25%) to 3:1000 (.30%) in autopsies and 1:125 (.80%) to 1:10000 (.01%) via bronchoscopy, and the detection rate of this disease is .06% by bronchoscopy in China. 3,5 TO is diagnosed with the widespread use of bronchoscopy, although the lesions are easily misdiagnosed.…”

“…With the development of CT as an alternative to bronchoscopy, the diagnosis rate has increased in recent years, although the accurate incidence of TO remains unclear. 2,3 There are still a number of misdiagnosed cases, revealing the need for a better understanding of the disease and its symptoms. Here, we present two cases that may provide a better description of TO and its indicators to assist in the identification and understanding of this disease.…”