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Tracheobronchopathia Osteochondroplastica

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Diseases of the Central Airways

Part of the book series: Respiratory Medicine ((RM))

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Abstract

Tracheobronchopathia osteochondroplastica (TO) is a rare disorder of unknown etiology, characterized by the development of multiple cartilaginous and bony nodules in the submucosal layer of central airways. The clinical presentation is non-specific with chronic cough, sputum production, intermittent hemoptysis, and breathlessness. In many patients, diagnosis is made incidentally on computed tomography (CT) or bronchoscopy performed for unrelated indications. Occasionally, patients present with acute respiratory distress, hypoxemia, and unanticipated difficulty during intubation. Although chest CT is the most useful imaging modality, the diagnosis can be missed in the early stages of disease. Bronchoscopy is the gold standard for diagnosis. The presence of hard nodules projecting into the lumen from anterior and lateral walls with sparing of posterior wall provides an instant diagnosis during bronchoscopy. Whether biopsy is needed for definitive diagnosis is a debatable matter. The majority of patients follow a benign clinical course. No treatment is needed in asymptomatic or minimally symptomatic patients. Adequate long-term control of symptoms can be achieved with laser photoresection and mechanical debulking in symptomatic patients with advanced central airway obstruction. Surgery may be needed in some patients if the interventional bronchoscopic procedures are not feasible. TO should feature in the differential diagnosis of chronic and persistent cough, hemoptysis, and treatment-resistant asthma.

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Authors and Affiliations

  1. Louis A Johnson VA Medical Center, Clarksburg, WV, 26301, USA

    Prasoon Jain

  2. Department of Pulmonary Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, OH, 44195, USA

    Atul C. Mehta

  3. Lerner College of Medicine, Buoncore Family Endowed Chair in Lung Transplantation, Respiratory Institute, Cleveland Clinic, Cleveland, OH, USA

    Atul C. Mehta

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Correspondence to Prasoon Jain .

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  1. Family Endowed Chair in Lung Transplanta, Lerner College of Medicine Buoncore, Clevland, Ohio, USA

    Atul C. Mehta

  2. Louis A Johnson VA Medical Center, Fairmont, West Virginia, USA

    Prasoon Jain

  3. Cleveland Clinic, Cleveland, Ohio, USA

    Thomas R. Gildea

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Jain, P., Mehta, A.C. (2016). Tracheobronchopathia Osteochondroplastica. In: Mehta, A., Jain, P., Gildea, T. (eds) Diseases of the Central Airways. Respiratory Medicine. Humana Press, Cham. https://doi.org/10.1007/978-3-319-29830-6_7

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