Tracheopathia osteoplastica.

Abstract

Tracheopathia osteoplastica is a rare condition and causes irregularity and narrowing of the trachea and sometimes the main bronchi. The characteristic feature is the presence of plaques of osseous material in the tracheal wall. Only three cases (Wilks, 1857; Bowen, 1959; Salm, 1961) have been reported in this country, and just over 100 cases are mentioned in the world literature. N.C., journalist, aged 55 years, male. Admitted to Westminster Hospital, October 24, 1967, complaining of three episodes of haemoptysis, cough, purulent sputum and rigors, occurring in the three months prior to admission and with good response to antibiotics. Chest radiographs during these episodes were said to show “slight opacity in the left lower zone”. One week before admission he was bronchoscoped at another hospital where a nodular tumour mass was found projecting from the left lateral wall of the left main bronchus near the left upper lobe orifice. A biopsy at this time showed only debris. However, carcinoma of the bronchus was considered the most likely diagnosis. On examination the patient was a fit looking man, apyrexial, and without finger clubbing. There were a few rhonchi in the left lower zone, but otherwise nil of note. Plain chest radiograph showed no significant abnormality (Fig. 1). Antero-posterior tomography of mediastinum and hilar regions (Fig. 2)—this showed an irregular attenuation of the lumen of the lower 7 cm of the trachea extending into the proximal 3 cm of the right main bronchus and the major part of the stem of the left main bronchus.