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.
Highlights
An 85-year-old Caucasian male ex-smoker with a history of chronic obstructive pulmonary disease and bronchiectasis presented to clinic with 2 to 3 weeks of gradual onset of vocal hoarseness
First descriptions of Tracheopathia osteoplastica (TPO) have been attributed to works by Rokitansky in 1855, Luschka in 1856, and Wilks in 1857.3 It usually manifests in adults in the sixth decade of life or later, with some pediatric cases having been reported.[1,2]
Typical presenting symptoms relate to airway stenosis and are nonspecific and can include dyspnea, hoarseness, cough, stridor, wheezing, or dysphagia
Summary
An 85-year-old Caucasian male ex-smoker with a history of chronic obstructive pulmonary disease and bronchiectasis presented to clinic with 2 to 3 weeks of gradual onset of vocal hoarseness.
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