Clinical analysis of one case of trachebronchomegaly and literature review

Abstract

Objective To improve understandings of clinical characteristics of tracheobronchomegaly (TBM) and reduce risks of missed diagnosis in clinical practice. Methods A case of TBM admitted to Beijing Tiantan Hospital was reported and 20 cases previously published in domestic literatures were reviewed. Results Of the total 21 involved patients, 20 cases were male with an average age of 54 years old.The most common clinical symptoms and physical signs were cough (95.24%), sputum (95.24%), shortness of breath (57.14%), bronchial rale and/or wheezing (66.67%). Featured imaging changes by chest CT scan were dilatation of the trachea and mainstem bronchi (100.00%), bronchiectasis (42.86%), tracheal diverticulosis (14.29%), and pulmonary bulla (23.81%). The average diameter of trachea in 18 patients was 36.1 mm, while the average diameters of left and right mainstem bronchus in 12 patients were 25.2 mm and 25.0 mm, respectively.The further analysis showed the diameter of trachea was not associated with age (r=-0.147, P=0.560) or disease duration of patients (r=0.337, P=0.201). Among 13 patients with bronchoscopy, increased tracheal diameter (100.00%), diverticulosis (46.15%) and trachea dysfunction (30.77%) were observed.There was no correlation between the diameter of trachea and trachea dysfunction (χ2=0.213, P=0.644). No patient was treated by trachea stent therapy to sustain their airway stabilization.One patient died of severe infection. Conclusions TBM is more common in male patients without specific clinical manifestations.The diagnosis of TBM is mainly based on measurement of trachea diameter.Bronchoscopy can facilitate early diagnosis of TBM and direct verification of tracheobronchomalacia. Key words: Tracheobronchomegaly; Retrospective studies; Diagnosis