[Tracheobronchopathia osteochondroplastica: a clinicopathological analysis of 18 cases]

Zhonghua Bing Li Xue Za Zhi. 2019 Apr 8;48(4):303-306. doi: 10.3760/cma.j.issn.0529-5807.2019.04.008.
[Article in Chinese]

Abstract

Objective: To investigate the clinical symptoms, imaging features, pathologic manifestations and diagnosis of tracheobronchopathia osteochondroplastica (TO). Methods: The clinical data, imaging and pathologic features and outcome of 18 TO patients diagnosed at the First Affiliated Hospital of Zhengzhou University from August 2011 to August 2018 were collected and analyzed. Results: The 18 TO patients included 10 males and 8 females; patients' age range was 31 to 64 years (mean 52 years). Six patients (6/18) were smokers. The main presenting clinical symptoms included cough in 15 cases, expectoration in eight cases (8/18), hemoptysis in five cases (5/18), chest tightness in four cases, wheezing in three cases and chest pain in two cases. The time interval between the initial symptoms and diagnosis was 1.5 to 360.0 months, and the average time interval was 45.2 months. Blood calcium and phosphorus were normal in 18 patients (18/18). Chest X-ray showed no direct evidence of TO. Six patients (6/18) showed irregular changes in the trachea or bronchial wall by chest CT scan. Three patients (3/18) had mild ventilatory obstruction. TO was classified as: 10 cases (10/18) were scattered type, seven cases (7/18) were diffuse type and one case (1/18) was confluent type. Epithelial squamous metaplasia, submucosal cartilage, submucosal ossification and hematopoietic bone marrow within the ossified areas were the characteristic histopathologic findings of TO. Conclusions: TO is a rare benign disorder that shows atypical presentation. CT scan is insensitive, the histopathology shows submucosal cartilage or ossification. TO should be diagnosed by comprehensive consideration of clinical symptoms, imaging and pathology.

目的: 探讨骨化性气管支气管病(tracheobronchopathia osteochondroplastica,TO)的临床特征、影像特点、病理表现及诊断要点。 方法: 收集2011年8月至2018年8月郑州大学第一附属医院18例TO患者的临床资料、影像特征及病理学表现,并进行随访。 结果: 18例TO患者中,男性10例,女性8例。年龄31~64岁,平均年龄52岁。6例(6/18)患者吸烟。主要的临床表现包括咳嗽15例、咳痰8例、咯血5例、胸闷4例、喘息3例、胸痛2例。从出现症状到确诊的时间为1.5~360.0个月,平均45.2个月。18例患者的血钙及血磷均正常。胸部X线片均无法直接提示此病。胸部CT扫描显示6例患者(6/18)有气管或支气管壁的不规则改变。肺功能测试有3例患者(3/18)有轻度的阻塞性通气障碍。TO分型:局限型10例(10/18),弥漫型7例(7/18),融合型1例(1/18)。12例(12/18)黏膜表面上皮鳞状化生,黏膜下可以见到结节状增生的软骨或骨组织,并可见到骨髓。 结论: TO是一种少见的良性病变,症状不典型,CT诊断阳性率低,组织病理学表现为结节状增生的软骨组织或骨组织,需要临床、影像与病理相结合综合诊断。.

Keywords: Bronchial diseases; Diagnosis, differential; Focal nodular hyperplasia; Tracheobronchopathia osteochondroplastica.

MeSH terms

  • Adult
  • Aged
  • Bronchi / diagnostic imaging
  • Cough / etiology
  • Female
  • Hemoptysis / etiology
  • Humans
  • Male
  • Middle Aged
  • Osteochondrodysplasias / complications*
  • Osteochondrodysplasias / diagnosis*
  • Tomography, X-Ray Computed
  • Tracheal Diseases / complications*
  • Tracheal Diseases / diagnosis*

Supplementary concepts

  • Tracheobronchopathia osteoplastica