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Devaraja K, Surendra VU. Clinicopathological Features and Management Principles of Tracheobronchopathia Osteochondroplastica - A Scoping Review. Indian J Otolaryngol Head Neck Surg 2023; 75:3798-3814. [PMID: 37974722 PMCID: PMC10646011 DOI: 10.1007/s12070-023-03998-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 06/16/2023] [Indexed: 11/19/2023] Open
Abstract
Tracheobronchopathia osteochondroplastica (TO) is an orphan disease of the tracheobronchial tree without any known etiological attributes. There are several case reports published on this condition, yet the available information about the TO is discrete and of little clinical value. This scoping review is the first large-scale review on TO that collates individual patient data from the published case reports and descriptively analyses the clinicopathological features of this unique condition along with its management approaches and therapeutic outcomes. The objective was to synthesize comprehensive literature review on TO that can aid clinical practice and further research. An electronic search conducted in five large databases, including PubMed, EMBASE, CINAHL, CENTRAL, and Web of Science, for the published articles of TO yielded 1072 items. After screening, the individual patient data of 371 TO cases from 228 eligible articles were included and analysed in this scoping review. Supplementary Information The online version contains supplementary material available at 10.1007/s12070-023-03998-6.
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Affiliation(s)
- K Devaraja
- Division of Head and Neck Surgery, Department of Otorhinolaryngology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka 576104 India
| | - Vyshak Uddur Surendra
- Department of Respiratory Medicine, Yenapoya Medical College Yenapoya University, Mangalore, Karnataka 575018 India
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Right Upper Lobe Shadow and Tracheobronchopathia Osteochondroplastica Confined to Right Main Bronchus: A Case Report and Literature Review. Case Rep Med 2015; 2015:368485. [PMID: 26681946 PMCID: PMC4670640 DOI: 10.1155/2015/368485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Accepted: 11/09/2015] [Indexed: 11/25/2022] Open
Abstract
Tracheobronchopathia osteochondroplastica (TO) is a well documented benign entity of endoscopic interest. We describe a case of 76-year-old patient who presented with fever, cough, purulent sputum during the past four days, and presence of an ovoid shadow in right upper zone of his chest X-ray. Medical history included diagnosis of colon diverticuli identified by colonoscopy 3 months ago. Chest CT revealed a compact elongated lesion containing air-bronchogram stripes. Bronchoscopy showed normal upper airways and trachea but presence of unequal sized mucosal nodules, protruding into the lumen, along the entire length of the right main bronchial mucosa. No other abnormal findings were detected. Moreover, brushing and washing smears from the apical segment of right upper lobe (RUL), where the compact lesion was located, were negative for malignancy. Biopsy from the mucosal nodules of right main bronchus showed presence of cartilaginous tissue in continuity through thin pedicles with submucosal cartilage. This finding posed the diagnosis of TO while RUL lesion was cleared by antibiotic treatment. Case is reported because, to our knowledge, it represents a unique anatomic location of TO which was confined exclusively in the right main bronchus mucosa without affecting trachea.
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Laine M, Elfihri S, Kettani F, Bourkadi JE. Tracheobronchopathia osteochondroplastica associated with skin cancer: a case report and review of the literature. BMC Res Notes 2014; 7:637. [PMID: 25212226 PMCID: PMC4167286 DOI: 10.1186/1756-0500-7-637] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Accepted: 09/08/2014] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Tracheobronchopathia osteochondroplastica (TO) is a rare disorder of unknown cause affecting the large airways. It is characterized by the accumulation of bony and cartilaginous nodules in the tracheal and bronchial mucosa. Approximately 300 cases of tracheobronchopathia osteochondroplastica have been reported since Wilks first identified it in 1857. Tomography and computed tomography scanning (CT) can be suggestive but final verification requires biopsy. Neoplastic disorders are, among others, blamed in etiology. We describe here, for the first time, a case of TO associated with skin cancer. CASE PRESENTATION A 40-year-old man with a scalp cancer was admitted for further evaluation of an occasional dry cough. Her medical history was otherwise unremarkable, and physical examination showed no abnormalities.The chest CT scan demonstrated multiple nodular densities in the trachea and proximal bronchi. The fiberoptic bronchoscopy showed multiple nodules in the trachea suggesting a malignant infiltration.Microscopic examination of the biopsy material revealed fragments of normal cartilage and bone formation with normal mucosa which confirmed the diagnosis of TO.Patient underwent surgery for scalp cancer. For TO, case has followed up. At twelve-month follow up, scalp tumor did not recur and cough ceased. CONCLUSION TO is a rare, benign disease that should be kept in mind especially in patients with tracheal irregularities in their chest imaging. Association with malignant tumors is reported.In patients with malignancy, TO can easily be misdiagnosed if it is not known as a diagnosis possibility of malignant invasion of the trachea. Therefore, it is important to be aware of this possibility, in order to prevent unnecessary treatments to patients.
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Affiliation(s)
- Mustapha Laine
- Departement of Pneumology, Moulay Youssef University Hospital Center, Faculty of Medicine and Pharmacy, Mohamed V University, 23 rue Belgrade, App 1, Ocean Rabat, Morocco.
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Abstract
We present a case of an elderly non-smoking gentleman who, since 2005, had been admitted multiple times for recurrent episodes of shortness of breath, wheeze, cough and sputum. The patient was treated as exacerbations of chronic obstructive pulmonary disease (COPD) and/or lower respiratory tract infections. Bronchoscopy was done which revealed multiple hard nodules in the trachea and bronchi with posterior tracheal wall sparing. Biopsies confirmed this as tracheopathia osteochondroplastica (TO). He had increasing frequency of admission due to methicillin-resistant Staphylococcus aureus and pseudomonas infections, which failed to clear despite intravenous, prolonged oral and nebulised antibiotics. The patient developed increasing respiratory distress and respiratory failure. The patient died peacefully in 2012. This case report highlights the typical pathological and radiological findings of TO and the pitfalls of misdiagnosing patients with recurrent chest infections as COPD.
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Affiliation(s)
- Ronstan Lobo
- Department of Medicine, St. John's Hospital, Limerick City, Limerick, Ireland.
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Raess PW, Cowan SW, Haas AR, Zhang PJ, Litzky LA, Miller WT, Cooper JD, Deshpande CG. Tracheobronchopathia osteochondroplastica presenting as a single dominant tracheal mass. Ann Diagn Pathol 2011; 15:431-5. [PMID: 21778098 DOI: 10.1016/j.anndiagpath.2011.04.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2011] [Revised: 04/19/2011] [Accepted: 04/20/2011] [Indexed: 12/13/2022]
Abstract
Tracheobronchopathia osteochondroplastica is a rare, benign disorder of upper airways characterized by multiple submucosal metaplastic cartilaginous and bony nodules arising from the tracheal cartilage. We report an unusual presentation of tracheobronchopathia osteochondroplastica as a single dominant nodule arising from the anterior tracheal rings in a young adult man who presented with wheezing and symptoms of airway obstruction. The differential diagnosis of cartilaginous and bony endotracheal lesions is discussed.
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Affiliation(s)
- Philipp W Raess
- Department of Pathology and Laboratory Medicine, Hospital of University of Pennsylvania, Philadelphia, PA 19104, USA
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Kırbaş G, Dağlı CE, Tanrıkulu AÇ, Yıldız F, Bükte Y, Şenyiğit A, Kıyan E. Unusual combination of tracheobronchopathia osteochondroplastica and AA amyloidosis. Yonsei Med J 2009; 50:721-4. [PMID: 19881980 PMCID: PMC2768251 DOI: 10.3349/ymj.2009.50.5.721] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2003] [Revised: 03/20/2004] [Accepted: 03/20/2004] [Indexed: 11/30/2022] Open
Abstract
Tracheobronchopathia osteochondroplastica (TO) is a rare disorder of unknown cause characterized by the presence of multiple submucosal osseous and/or cartilaginous nodules that protrude into the lumen of the trachea and large bronchi. A simultaneous diagnosis of TO and amyloidosis is rarely reported. In this report, a case initially suspected to be asthma bronchiole that could not be treated, was radiologically diagnosed as TO, and also secondary amyloidosis is presented. A 53 years, man patient reported a 3 years history of dyspnea. Pulmonary function tests (PFTs) showed an obstructive pattern. Chest X-rays revealed right middle lobe atelectasis. FOB and CT detected nodular lesions in the trachea and in the anterior and lateral walls of the main bronchi. AA amyloidosis was confirmed by endobronchial biopsy. In the abdominal fat pad biopsy, amyloidosis was not detected. Asthma bronchiole was excluded by PFTs. This case illustrates that it is possible for TO and amyloidosis to masquerade as asthma. TO and amyloidosis should be suspected in patients of older ages with asthma and especially with poorly treated asthmatic patients. Although nodular lesions in the anterior and lateral tracheobronchial walls are typical for TO, a biopsy should be obtained to exclude amyloidosis.
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Affiliation(s)
- Gökhan Kırbaş
- Department of Chest Diseases, Faculty of Medicine, University of Dicle, Diyarbakır, Turkey
| | - Canan Eren Dağlı
- Department of Chest Diseases, Faculty of Medicine, University of Dicle, Diyarbakır, Turkey
| | | | - Fetin Yıldız
- Department of Pathology, Diyarbakır State Hospital, Diyarbakır, Turkey
| | - Yaşar Bükte
- Department of Radiodiagnostics, Faculty of Medicine, University of Dicle, Diyarbakır, Turkey
| | - Abdurrahman Şenyiğit
- Department of Chest Diseases, Faculty of Medicine, University of Dicle, Diyarbakır, Turkey
| | - Esen Kıyan
- Department of Chest Diseases, Cerrahpasa Faculty of Medicine, University of Istanbul, Istanbul, Turkey
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Tracheopathia chondro-osteoplastica--an unusual cause of stridor. The Journal of Laryngology & Otology 2008; 123:1039-41. [PMID: 18854058 DOI: 10.1017/s0022215108003721] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES A case of tracheopathia chondro-osteoplastica causing sub-glottic stenosis is described. STUDY DESIGN Case report and literature review. MATERIALS AND METHODS A 37-year-old man presented with a 15-year history of gradually worsening dyspnoea and stridor due to sub-glottic stenosis. His medical and radiographic records were reviewed. This patient's presentation, histopathological findings and radiology images are presented and discussed. RESULTS Histopathological evaluation of microlaryngoscopy biopsy specimens, taken during laser debulking of the stenosis, confirmed the presence of tracheopathia chondro-osteoplastica. CONCLUSIONS This is the first reported case of sub-glottic stenosis caused by tracheopathia chondro-osteoplastica which required an urgent tracheostomy.
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Jabbardarjani HR, Radpey B, Kharabian S, Masjedi MR. Tracheobronchopathia osteochondroplastica: presentation of ten cases and review of the literature. Lung 2008; 186:293-7. [PMID: 18463923 DOI: 10.1007/s00408-008-9088-4] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2008] [Accepted: 03/13/2008] [Indexed: 10/22/2022]
Abstract
Tracheobronchopathia osteochondroplastica (TO) is a rare benign disease of the endobronchial system with nonspecific symptoms and different treatment approaches. We report on a group of patients with TO and discuss their presentation and their treatment modalities. Between 2000 and 2006, the medical records of patients with TO were studied at the Interventional Pulmonary Unit of the Tracheal Disease Research Center at Masih Daneshvary Hospital, a referral center for respiratory diseases in Tehran, Iran. We analyzed and studied patients' demographics, symptom presentation, radiographic appearance, bronchoscopic findings, and their subsequent treatment. Of the 8,760 patients who underwent flexible bronchoscopy (FOB) at our center over 6 years, 10 were diagnosed with TO; their median age was 51 years (range = 16-68 years) and 6 were men. Computerized tomography (CT) revealed mucosal irregularity and calcified nodules. Histopathologic examination of tissue biopsy through bronchoscopy was used for definitive diagnosis of TO. Bronchoscopy findings showed the endobronchial lesions to be firm and glossy. Cartilaginous nodules were present in central airways. Treatment included endobronchial Nd:YAG laser photoevaporation (LPE) (n = 10), coring of the lesions with the tip of the rigid bronchoscope (n = 4), and endobronchial stent placement (n = 1). Symptoms were considerably relieved in six cases but there was no significant improvement noted in three patients. One patient died after 6 years of treatment and follow-up. TO is a rare disease and the diagnosis should be suspected based on CT findings or bronchoscopic examination of the airways. Histopathologic examination is required for confirmation of diagnosis. Treatment is palliative and it includes LPE, coring through a rigid bronchoscope, and endobronchial stent placement.
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Affiliation(s)
- Hamid Reza Jabbardarjani
- Tracheal Disease Research Center, NRITLD, Massih Daneshvari Hospital, Shahid Beheshti University, M.C., Tehran, Iran.
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Oh IJ, Ju JY, Choi YD. Tracheopathia Osteochondroplastica with Recurrent Massive Hemoptysis and Atelectasis: A Case Report. Tuberc Respir Dis (Seoul) 2008. [DOI: 10.4046/trd.2008.65.3.235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- In Jae Oh
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Jin Young Ju
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Yoo Duk Choi
- Department of Pathology, Chonnam National University Medical School, Gwangju, Korea
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Leske V, Lazor R, Coetmeur D, Crestani B, Chatté G, Cordier JF. Tracheobronchopathia osteochondroplastica: a study of 41 patients. Medicine (Baltimore) 2001; 80:378-90. [PMID: 11704714 DOI: 10.1097/00005792-200111000-00004] [Citation(s) in RCA: 80] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- V Leske
- Centre d'Etudes et de Recherche sur les Maladies "Orphelines" Pulmonaires, Hôpital Louis Pradel, Université Claude Bernard, Lyon, France
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Saint-Blancard P, Natali F, Vaylet F, Coutant G, L'Her P, Le Vagueresse R. [Osteochondroplastic tracheobronchopathy: 5 cases]. Rev Med Interne 1998; 18:882-7. [PMID: 9499989 DOI: 10.1016/s0248-8663(97)81962-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Five new cases of tracheobronchopathia osteochondroplastica (TBOCP) are reported and clinical, radiological and pathological features are reviewed. TBOCP is a rare disease characterized by cartilaginous and bony nodules lining the mucosa of the trachea and major bronchi. The endoscopic features realize pathological evolution by stadiums. The prognosis is usually favourable. The etiology of TBOCP remains unknown, even though some cases were reported in association with amyloidosis.
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Affiliation(s)
- P Saint-Blancard
- Service d'anatomie pathologique, hôpital d'instruction des Armées Percy, Clamart, France
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