SDMRad

 Radiological Findings, Disease course, and Management

 

 CT Neck

     

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 Findings

• Multiple calcified nodules in the submucosa of anterior and lateral walls of trachea and bronchi

• Posterior wall is spared

 Impression

 Tracheobronchopathia Osteochondroplastica

 

 Discussion

   Background

• very rare idiopathic non neoplastic tracheo-bronchial abnormality

• typically affects those in the 5th to 6th decades

• may be a male predilection  

• Most patients asymptomatic

• Symptomatic patients may present with cough, shortness of breath on exertion, wheezing or recurrent respiratory infection 

    Haemoptysis can occasionally result from an ulceration of a nodule or an     acute infection. 

• Development of osseous or cartilaginous 1-8mm, 2-3 nodules or both in the submucosa of the trachea and bronchial walls.

    may be either focal or diffuse

    characterisitic sparing of the posterior membranous portions of the         trachea

• There are two possible theories of pathogenesis: 

    - ecchondrosis and exostosis from cartilage rings

    - cartilaginous and osseous metaplasia of the elastic tissue in the             internal elastic fibrous membrane. 

• Location

    -classically affects the lower 2/3rds of the trachea and proximal             portions of the bronchi 

    -only affects the anterior and lateral walls

 

 Imaging findings

 Radiography

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 Chest radiograph

• May show irregularity and narrowing of the typically affected segments of the trachea and bronchi

 CT

• thickened tracheal cartilages with sparing of posterior membranous portions

• small (typically ~3-8 mm) calcific nodules along its inner tracheal aspect, protruding into the tracheal lumen

 Differential diagnosis

• tracheobronchial amyloidosis: involves the posterior membranous portion of the trachea

• relapsing polychondritis: spares the posterior membranous portion of the trachea

 

 Treatment and prognosis 

• often no intervention in required in asymptomatic cases

• Successful recovery with NSAIDS and Dapsone have been reported in symptomatic cases

• Overall prognosis depends on airway stenosis caused by nodules  

 

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References

• Weerakkody, Y. (n.d.). Tracheobronchopathia osteochondroplastica | Radiology Reference Article. Retrieved from https://radiopaedia.org /articles/tracheobronchopathia-osteochondroplastica