Tracheobronchopathia Osteochondroplastica: A Case Report Illustrating the Importance of Multilevel Workup Clinical, Endoscopic and Histological Assessment in Diagnosis of an Uncommon Disease
Giulio Riva, Ilaria Girolami, Claudio Luchini, Manuela Villanova, Giovanni Valotto, Luca Cima, Rodolfo Carella, Maurizio Riva, Filippo Fraggetta, Luca Novelli, Albino Eccher
(Pathology Unit, Department of Pathology and Diagnostics, University and Hospital Trust of Verona, Verona, Italy)
Am J Case Rep 2019; 20:74-77
Tracheobronchopathia osteochondroplastica (TO) is a rare idiopathic disease with a stable course, which involves the lumen of the tracheobronchial tree. Clinical manifestations at time of presentation may differ, typically including hoarseness, persistent and/or productive cough, hemoptyses, and dyspnea. There are no well-established guidelines for diagnostic workup and treatment. Our aim here is to present a paradigmatic case of TO together with a concise survey of the most important clinical, radiological, and histological criteria.
CASE REPORT: We report a case of a 62-year-old non-smoker male with persisting cough and no prior history of respiratory disease. Chest radiography (RX) and computed tomography (CT) were unremarkable. Given the persistence of symptoms, the patient underwent bronchoscopic examination, which revealed protruding sessile nodules into the tracheal lumen, with cobblestone appearance. Histopathological examination of biopsies taken during bronchoscopy showed cartilaginous and osseous submucosal nodules consistent with the diagnosis of TO.
CONCLUSIONS: TO is not always an easily recognized disease, and a multidisciplinary team work is often required for diagnosis, with particular importance of endoscopic-pathological correlation.
Keywords: Bronchoscopy, Osteochondrodysplasias, Tracheal Diseases