A clinical study of tracheobronchopathia osteochondroplastica: findings from a large Chinese cohort.

Ying Zhu,Qiang Li,Ning Wu,Wei Zhang,Yu-Chao Dong,Qin Wang,Qin-Ying Sun,Hai-Dong Huang,Paul Proost

doi:10.1371/journal.pone.0102068

Ying Zhu, Qiang Li + Show 7 more

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https://doi.org/10.1371/journal.pone.0102068

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Journal: PloS one	Publication Date: Jul 11, 2014
Citations: 42	License type: CC BY 4.0

Affiliation: Second Military Medical University, Changhai Hospital

Abstract

Background and Study AimsTracheobronchopathia osteochondroplastica (TO) is an uncommon disease of the tracheobronchial system that leads to narrowing of the airway lumen from cartilaginous and/or osseous submucosal nodules. The aim of this study is to perform a detailed review of this rare disease in a large cohort of patients with TO proven by fiberoptic bronchoscopy from China.Patients and MethodsRetrospective chart review was performed on 41,600 patients who underwent bronchoscopy in the Department of Respiratory Medicine of Changhai Hospital between January 2005 and December 2012. Cases of TO were identified based on characteristic features during bronchoscopic examination.Results22 cases of bronchoscopic TO were identified. Among whom one-half were male and the mean age was 47.45±10.91 years old. The most frequent symptoms at presentation were chronic cough (n = 14) and increased sputum production (n = 10). Radiographic abnormalities were observed in 3/18 patients and findings on computed tomography consistent with TO such as beaded intraluminal calcifications and/or increased luminal thickenings were observed in 18/22 patients. Patients were classified into the following categories based on the severity of bronchoscopic findings: Stage I (n = 2), Stage II (n = 6) and Stage III (n = 14). The result that bronchoscopic improvement was observed in 2 patients administered with inhaled corticosteroids suggested that resolution of this disease is possible.ConclusionsTO is a benign disease with slow progression, which could be roughly divided into 3 stages on the basis of the characteristic endoscopic features and histopathologic findings. Chronic inflammation was thought to be more important than the other existing plausible hypotheses in the course of TO. Inhaled corticosteroids might have some impact on patients at Stage I/II.

Highlights

Radiographic abnormalities were observed in 3/18 patients and findings on computed tomography consistent with Tracheobronchopathia osteochondroplastica (TO) such as beaded intraluminal calcifications and/or increased luminal thickenings were observed in 18/22 patients
TO is a benign disease with slow progression, which could be roughly divided into 3 stages on the basis of the characteristic endoscopic features and histopathologic findings
Tracheobronchopathia osteochondroplastica (TO) is a rare benign disorder of unknown etiology, characterized by the presence of multiple cartilaginous and/or osseous submucosal nodules protruding into the lumen of lower two thirds of the trachea and upper part of the main bronchi [1]

Summary

Introduction

Tracheobronchopathia osteochondroplastica (TO) is a rare benign disorder of unknown etiology, characterized by the presence of multiple cartilaginous and/or osseous submucosal nodules protruding into the lumen of lower two thirds of the trachea and upper part of the main bronchi [1]. TO was previously an incidental finding at autopsy due to its usually benign progression and lack of typical symptoms. It is presently increasingly discovered through bronchoscopy and/or chest computed tomography (CT) [5]. The etiology of TO is still unclear and there’s no standard treatment guideline In this retrospective study, we tried to provide a better description of the whole picture of TO, including the most probable etiology and appropriate medical management based on our findings.

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