Clinical characteristics of tracheobronchopathia osteochondroplastica

Abstract

BACKGROUND: Tracheobronchopathia osteochondroplastica (TO) consists of benign lesions of tracheal and bronchial mucosa with multiple nodular hyperplasia of bone or cartilage protruding into the lumen. METHODS: We diagnosed 73 subjects with TO with the use of bronchoscopy in the Department of Respiratory and Critical Care Medicine of Xiangya Hospital between January 2000 and April 2017. Clinical manifestations, radiographic characteristics, bronchoscopic manifestations, histopathological findings, and treatments were analyzed retrospectively. RESULTS: Subjects included 30 women and 43 men (mean age, 52.8 + 11.7 y). Twenty-seven subjects were diagnosed with other diseases, including tuberculosis in 11 subjects, carcinoma in 13, bronchiectasis in 2, and pulmonary hamartomas in 1 subject. The most common symptom was cough (n = 34). Other initial manifestations included hemoptysis (n = 17), expectoration (n = 15), and chest pain (n = 8). Of those who underwent a computed tomography scan in our hospital, 28 of 32 subjects had noted calcification of the tracheal wall, with 4 of 32 subjects appearing normal. Bronchoscopy revealed typical accumulation of diffuse cartilaginous and osseous nodules of TO, and 9 had observable tracheal stenosis. Histopathologic results included the presence of chronic inflammation (n = 47), ossification (n = 38), and cartilage formation (n = 10). Most subjects received symptomatic treatment, although 3 subjects with severe airway obstruction received bronchoscopic treatment. CONCLUSION: The results indicated that TO lacks clinical specificity, which means that special therapy and bronchoscopy with histopathological and radiographic assistance is important for its diagnosis. The treating physicians’ awareness about this condition is also important to its diagnosis and management.