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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Abali H. A rare case of rapidly progressive Tracheobronchopathia Osteochondroplastica. Respir Med Case Rep 2023; 43:101853. [PMID: 37124055 PMCID: PMC10131121 DOI: 10.1016/j.rmcr.2023.101853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 04/11/2023] [Accepted: 04/14/2023] [Indexed: 05/02/2023] Open
Abstract
Tracheobronchopathia Osteochondroplastica (TO) is a rare benign disorder that is seldom progressive. Here, we report a case diagnosed with TO in our hospital. Bronchoscopy revealed multiple cartilaginous and ossifying nodules that are diagnostic for TO. Nodules protruding into the airways were observed as widespread and extended by the repeat bronchoscopy after 2 months of the diagnosis. TO was confirmed with the histopathology of the biopsies from nodules. Then he was referred to an interventional pulmonologist for laser ablation.
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Affiliation(s)
- Hulya Abali
- Kazlıcesme, 34020, Zeytinburnu, Health Sciences University, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey.
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Gandhi S, Puneeth PJ, Balushi F. The Rocks Valley: Tracheopathia Osteochondroplastica: A Case Report. Indian J Otolaryngol Head Neck Surg 2022; 74:5703-5705. [PMID: 36742860 PMCID: PMC9895340 DOI: 10.1007/s12070-021-03051-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 12/27/2021] [Indexed: 02/07/2023] Open
Abstract
Tracheopathia Osteochondroplastica is a rare benign tracheobronchial condition. Its unspecific symptoms and high clinical threshold for diagnosis make the condition an incidental diagnosis. We report an incidental tracheopathia osteochondplastica in 66 years old male patient with suspected thyroid malignancy.
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Affiliation(s)
- Sachin Gandhi
- Deenanath Mangeshkar Hospital and Research Centre, Pune, 411004 India
| | - P. J. Puneeth
- Deenanath Mangeshkar Hospital and Research Centre, Pune, 411004 India
| | - Firyal Balushi
- Deenanath Mangeshkar Hospital and Research Centre, Pune, 411004 India
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Dumazet A, Launois C, Lebargy F, Kessler R, Vallerand H, Schmitt P, Hermant C, Dury S, Dewolf M, Dutilh J, Abouda M, Ferreira M, Atallah I, Lachkar S, Charriot J, Jouneau S, Uzunhan Y, Chouabe S, Coiffard B, Dutau H, Hagenburg J, Briault A, Dormoy V, Lirsac M, Vergnon JM, Deslee G, Perotin JM. Tracheobronchopathia osteochondroplastica: clinical, bronchoscopic, and comorbid features in a case series. BMC Pulm Med 2022; 22:423. [PMID: 36397041 PMCID: PMC9670617 DOI: 10.1186/s12890-022-02225-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 11/04/2022] [Indexed: 11/18/2022] Open
Abstract
Background Tracheobronchopathia osteochondroplastica (TO) is a rare condition of unknown etiology. TO is characterized by submucosal nodules, with or without calcifications, protruding in the anterolateral walls of the trachea and proximal bronchi. The objective of this study was to describe TO features and associated comorbidities in a series of patients. Methods Patients suffering from TO were retrospectively included by investigators from the Groupe d’Endoscopie Thoracique et Interventionnelle Francophone (GETIF). Demographic, clinical, comorbidities, bronchoscopic, functional, and radiological characteristics, and outcomes were recorded and analyzed. Results Thirty-six patients were included (69% male with a mean of 65 ± 12 years). Chronic symptoms were described by 81% of patients including cough (74%) and dyspnea on exertion (74%). TO was associated with COPD in 19% of the cases and gastroesophageal reflux disease in 6%. A mild to severe airflow obstruction was present in 55% of the cases. CT scan showed tracheal submucosal nodules in 93% of patients and tracheal stenosis in 17%. Bronchoscopy identified TO lesions in the trachea in 65% of the cases, and 66% of them were scattered. A bronchoscopic reevaluation was performed in 7 cases, 9 ± 14 months [1–56] after initial diagnosis, and showed the stability of lesions in all cases. Three patients underwent interventional bronchoscopic treatment. Conclusion The diagnosis of TO relies on typical bronchoscopic findings and can be evoked on a CT scan. Histologic diagnosis can be useful in atypical cases for differential diagnosis. Given its low consequences in terms of symptoms, lung functions, and evolution, no treatment is usually required.
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Affiliation(s)
- Nader Kamangar
- University of California Los Angeles David Geffen School of Medicine, CA.
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Nazarochkin YV, Butyrina EV, Ob'etanov AA. [Extended laryngotracheal stenosis and osteochondroplastic tracheopathy]. Vestn Otorinolaringol 2015; 80:70-72. [PMID: 26145750 DOI: 10.17116/otorino201580270-72] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The present article was designed to report a case of the surgical treatment of the patient presenting with extended laryngotrachealstenosis related toosteochondroplasticlaryngo- and tracheopathy. The development of the osteochondroplastic transformation of the laryngeal and tracheal walls was regarded as a single pathomorphologicalprocess associated with chronic inflammation. The study has demonstrated the relationship between the squamous cell hyperplasia in the epithelium of the upper respiratory tract and destructive chondro-perichondritis of the larynx and trachea accompanied by osteochondroplastic changes and concomitant extended laryngotracheal stenosis.
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Affiliation(s)
- Yu V Nazarochkin
- Astrakhan Branch of the Research and Clinical Centre of Otorhinolaryngology, Russian Federal Medico-Biological Agency, Astrakhan, Russia, 414040; Astrakhan State Medical University, Russian Ministry of Health, Astrakhan, Russia, 414040
| | - E V Butyrina
- Astrakhan Branch of the Research and Clinical Centre of Otorhinolaryngology, Russian Federal Medico-Biological Agency, Astrakhan, Russia, 414040
| | - A A Ob'etanov
- Astrakhan State Medical University, Russian Ministry of Health, Astrakhan, Russia, 414040
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Abstract
We report a patient with tracheopathia osteoplastica (TPO), a rare or perhaps underrecognized disorder, detected in approximately 1 in every 2000 to 5000 patients who undergo bronchoscopy. TPO is marked by proliferation of bony and cartilaginous spurs leading to airway stenosis. Multiple submucosal cartilaginous and osseous nodules can develop in the respiratory tract and may involve the entire trachea and mainstem bronchi. Symptoms may range from a completely silent condition to life-threatening respiratory failure and diagnosis is made based on radiological and bronchoscopic findings. Although the etiology has not been established, TPO can be familial and is sometimes associated with chronic inflammation, such as seen with rheumatic diseases. This case highlights the need for understanding TPO so that it can be differentiated from potentially serious conditions such as necrotizing granulomatous diseases, invasive infections, and cancer.
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Affiliation(s)
- Sassan Rafizadeh
- University of California, Davis Medical Center, Sacramento, CA, USA
| | - Ken Yoneda
- University of California, Davis Medical Center, Sacramento, CA, USA
| | - Amir A. Zeki
- University of California, Davis Medical Center, Sacramento, CA, USA
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Danckers M, Raad RA, Zamuco R, Pollack A, Rickert S, Caplan-Shaw C. A complication of tracheobronchopathia osteochondroplastica presenting as acute hypercapnic respiratory failure. Am J Case Rep 2015; 16:45-9. [PMID: 25629203 PMCID: PMC4311905 DOI: 10.12659/ajcr.892427] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Accepted: 10/21/2014] [Indexed: 11/09/2022]
Abstract
BACKGROUND Tracheobronchopathia osteochondroplastica is a rare benign and often indolent disease. We report the first case of tracheobronchopathia osteochondroplastica (TBO) presenting as acute hypercarbic respiratory failure due to superimposed subglottic submucosal abscess. CASE REPORT A 27-year-old man presented to the emergency department in respiratory distress that required mechanical ventilation for acute hypercarbic respiratory failure. Upon extubation the next day, stridor was elicited with ambulation. Spirometry revealed fixed upper airway obstruction. Neck imaging showed a 2.8 × 2.0 × 4.0 cm partially calcified subglottic mass with cystic and solid component obstructing 75% of the airway. Surgical exploration revealed purulent drainage upon elevation of the thyroid isthmus and an anterolateral cricoid wall defect in communication with a subglottic submucosal cavity. Microbiology was negative for bacteria or fungi. Pathology showed chondro-osseous metaplasia compatible with tracheobronchopathia osteochondroplastica (TBO). The patient received a course of antibiotics and prophylactic tracheostomy. Since tracheostomy removal 3 days later, the patient remains asymptomatic. CONCLUSIONS Tracheobronchopathia osteochondroplastica is a rare disease with usually benign clinical course and incidental diagnosis. It may present as acute hypercarbic respiratory failure when subglottic infection is superimposed.
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Affiliation(s)
- Mauricio Danckers
- Division of Pulmonary, Critical Care and Sleep Medicine, New York University Langone Medical Center, New York, NY, U.S.A
| | - Roy A. Raad
- Department of Radiology, New York University Langone Medical Center, New York, NY, U.S.A
| | - Ronaldo Zamuco
- Department of Pathology, New York University Langone Medical Center, New York, NY, U.S.A
| | - Aron Pollack
- Division of Otolaryngology, New York University Langone Medical Center, New York, NY, U.S.A
| | - Scott Rickert
- Division of Otolaryngology, New York University Langone Medical Center, New York, NY, U.S.A
| | - Caralee Caplan-Shaw
- Division of Pulmonary, Critical Care and Sleep Medicine, New York University Langone Medical Center, New York, NY, U.S.A
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Abstract
Tracheobronchopathia osteochondroplastica (TO) is a rare large-airway disorder of unknown cause, characterized by the development of multiple submucosal osseous and/or cartilaginous nodules that protrude into the lumen of the trachea and large bronchi. Although most patients are asymptomatic, some may present with nonspecific respiratory symptoms. A chest computed tomographic scan with multiple protruding nodules in the trachea is suggestive but other diagnoses can present with a similar appearance; hence, definitive diagnosis may require bronchoscopic examination. Numerous cases of TO have been reported in association with different diseases, but no definitive causative explanation has been shown with any of the conditions. Chronic airway inflammation is one of the proposed mechanisms to explain the formation of TO nodules. Most of the reported TO patients have a history of frequent airway infections. Patients with IgA deficiency present with frequent sinopulmonary infections. The present case illustrates the first case of TO associated with IgA deficiency.
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Savelli S, Grata ML, Ricci A, Gamberini S, Manfredini R. An unusual cause of recurrent hemoptysis: tracheopatia osteoplastica. Intern Emerg Med 2010; 5:437-8. [PMID: 20177817 DOI: 10.1007/s11739-010-0365-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2009] [Accepted: 02/01/2010] [Indexed: 10/19/2022]
Affiliation(s)
- Sandra Savelli
- U.O. di Medicina Interna, Ospedale del Delta, Azienda U.S.L. di Ferrara, Ferrara, Italy
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Affiliation(s)
| | | | | | - Latife Candan
- Pathology, Trakya University Faculty of Medicine, Edirne, Turkey
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Willms H, Wiechmann V, Sack U, Gillissen A. Tracheobronchopathia osteochondroplastica: A rare cause of chronic cough with haemoptysis. Cough 2008; 4:4. [PMID: 18590564 PMCID: PMC2464583 DOI: 10.1186/1745-9974-4-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2008] [Accepted: 06/30/2008] [Indexed: 11/10/2022]
Abstract
A case of tracheobronchopathia osteochondroplastic (TPO) was diagnosed in a 69-year old male with prolonged cough. TPO is a rare condition of unknown cause and only sporadic cases have been reported. The condition is benign, characterized by submucosal nodules growing from the submucosal layer of the airways, protruding into the bronchial lumen. The bronchscopic view together with bronchial cartilage with abnormal distributed mineralization of the histologic examination of theses nodules leads to the correct diagnosis. Mild cases are treated symptomatically, whereas we tried an inhaled corticosteroid. Prominent protrusions in the trachea or the bronchi must be removed. In most cases the disease is stable over years but progressive forms have been reported. TPO may cause chronic refractory cough, which eventually is the only prominent symptom of this disease.
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Affiliation(s)
- Hinrich Willms
- Robert-Koch-Hospital, St, George Medical Center, Nikolai-Rumjanzew-Str, 100, D-4207 Leipzig, Germany
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Abstract
INTRODUCTION We report a case of tracheobronchopathia osteochondroplastica associated with Ozena (atrophic rhinitis). OBSERVATION Fibreoptic bonchoscopy showed irregular tracheal stenosis and histopathological examination displayed zones of bone metaplasia in the tracheal submucosa. We isolated the bacteria Klebsiella pneumoniae sp ozaenae from bronchial aspirate. CONCLUSION This organism is frequently isolated in both conditions suggesting some link between the two diseases.
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Affiliation(s)
- P Magro
- Service de Pneumologie, CHU Bretonneau, Tours, France.
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Affiliation(s)
- Robert J Tibesar
- Department of Otorhinolaryngology, Division of Pulmonary and Critical Care Medicine and Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA
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Abstract
The case of a male, 61 years of age, presenting with occasional hemoptysis and shortness of breath (duration of 1 year) is reported. Congestive heart failure was presumed and supported by chest x-ray and echocardiography. The patient improved with diuretic and angiotensin converting enzyme (ACE) inhibitor therapy, but continued to experience cough and occasional hemoptysis. Bronchoscopy revealed numerous firm nodular projections within the trachea with distribution along the cartilaginous rings. Tracheopathia osteochondroplastica (TPO) was diagnosed. TPO is an uncommon, benign, but slowly progressive disease of unknown etiology. It is characterized by endoluminal projection of cartilaginous and bony nodules arising in the submucosa of the trachea. Involvement may extend to lobar or segmental bronchi. TPO should be considered in cases where cough, dyspnea, persistent pulmonary infection, hoarseness, or recurrent hemoptysis remain after appropriate treatment of other presumptive underlying causes.
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Affiliation(s)
- Kashif Hussain
- Department of Pulmonary-Critical Care, University of Wisconsin Hospital, Madison, Wisconsin 53791, USA.
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Moura e Sá J, Almeida J, Amado J, Fernandes B, Caminha J, Ferraz JM. Traqueobroncopatia osteocondroplástica. Revista Portuguesa de Pneumologia 2002; 8:329-40. [DOI: 10.1016/s0873-2159(15)30773-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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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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Abstract
Tracheal botryomycosis has never been reported in the literature. A 68 year old man presented with progressive dyspnoea and an exophytic mass below the vocal cords was found by bronchoscopy. Pathological study of the mass showed tracheal botryomycosis probably associated with Peptostreptococcus spp infection. The patient was given intravenous penicillin for six weeks. Tracheal obstruction necessitated tracheal resection and the surgical specimen revealed typical findings of tracheopathia osteochondroplastica without residual lesions of botryomycosis.
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Affiliation(s)
- J Y Shih
- Department of Internal Medicine, National Taiwan University Hospital, Taipei
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Abstract
A case of tracheobronchopathia osteochondroplastica (TO) was diagnosed in a 68-year-old male with prolonged cough. A bronchoscopy revealed multiple nodular excrescences along the anterolateral wall of the trachea and main bronchi. Tissue specimens showed pronounced change of bronchial cartilage with massive mineralization diagnostic for TO. The literature on the subject is reviewed here. The aetiology and pathogenesis is unknown. The severity of TO range from no symptoms to severe dyspnoea, haemoptysis or pneumonitis. Treatment is seldom necessary. However, in severe cases, bronchoscopic removal of obstructing excrescences and surgery has been performed with therapeutic effect. Differential diagnosis of nodular excrescences includes amyloidosis, endobronchial sarcoidosis, calcificating lesions of tuberculosis, papilomatosis and tracheobronchial calcinosis. Awareness of the condition as a differential diagnosis to neo-plasms is important, to avoid unnecessary surgery or chemotherapy.
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Affiliation(s)
- C N Meyer
- Medical Department P, Bispebjerg Hospital, Copenhagen, Denmark
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Akyol MU, Martin AA, Dhurandhar N, Miller RH. Tracheobronchopathia Osteochondroplastica: A Case Report and a Review of the Literature. Ear Nose Throat J 1993. [DOI: 10.1177/014556139307200509] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- M. Umut Akyol
- Tulane University Medical School, Department of Otolaryngology-Head & Neck Surgery, New Orleans, LA
| | - Andrew A. Martin
- Tulane University Medical School, Department of Pathology, New Orleans, LA
| | - Nina Dhurandhar
- Tulane University Medical School, Department of Pathology, New Orleans, LA
| | - Robert H. Miller
- Tulane University Medical School, Department of Otolaryngology-Head & Neck Surgery, New Orleans, LA
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