Kosin Med J.  2018 Dec;33(2):200-207. 10.7180/kmj.2018.33.2.200.

Pulmonary tuberculosis occurred in patient with Tracheobronchopathia Osteochondroplastica

• Shim JW
• Kim JH
• Jang YW
• Sung YM
• Kim N
• Lee SM

• KMID: 2430735
• DOI: http://doi.org/10.7180/kmj.2018.33.2.200

Abstract

Tracheobronchopathia osteoplastica (TO) is a rare benign disease in which the anterior inner wall of the tracheobronchus changes because of abnormal chondrogenesis or ossification, while the posterior wall of the trachea is spared. The etiology is not clearly understood, but may relate with chronic infection, inflammation, and trauma. In some case studies, it has also been reported to be accompanied by other chronic diseases such as atrophic rhinitis and amyloidosis. However, Coexistence of TO and tuberculosis has rarely been reported, and has never been reported in Korea. Here, we report a case of a 70-year-old male patient who complained of hemoptysis and whose case was diagnosed as TO and pulmonary tuberculosis through bronchoscopy with bronchial washing and biopsy.

Keyword

Tracheobronchopathia osteoplastica; Tuberculosis

MeSH Terms

Aged
Amyloidosis
Biopsy
Bronchoscopy
Chondrogenesis
Chronic Disease
Hemoptysis
Humans
Inflammation
Korea
Male
Rhinitis, Atrophic
Trachea
Tuberculosis
Tuberculosis, Pulmonary*

Figure

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  Fig. 1 Chest X-ray reveals multiple nodular opacities in the right upper lung field (arrows) with a 40 × 15 mm2 focal opacity in the right middle lung field (arrowhead).

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  Fig. 2 Chest computed tomography shows clustered centrilobular nodules (arrows with solid line) and ground glass attenuation (arrows with dashed line) in the right upper lobe and the superior segment of the right lower lobe (A), with endotracheal nodules on the right wall of the interior two-thirds of the trachea (arrowhead) (B).

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  Fig. 3 Bronchoscopy reveals multiple whitish nodules and patches in the lower trachea above carina (A) and two nodules (arrows) in the bronchus of the right middle lobe (B).

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  Fig. 4 Biopsy sample with lamellar structures which are similar to cortical bone. Polarized light makes the lamellar structures more visible. (polarized light, hematoxylin and eosin, ×200).

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  Fig. 5 Osseous tissue with marrow spaces is found just beneath the pseudostratified respiratory epithelium. The marrow cavity is filled with some erythropoietic cells and mature adipose tissue. At the periphery, a focal remnant of hyaline cartilage is seen. Collectively, these histological findings indicate tracheobronchopathia osteoplastica (hematoxylin and eosin, ×200).

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