Bony Nodules Research Articles

Tracheobronchopathia Osteochondroplastica: A Rare Large Airway Disorder

Tracheobronchopathia osteochondroplastica (TO) is a rare disorder of the large airways characterized by the development of submucosal cartilaginous and bony nodules. The nodules involve the anterior and lateral walls and typically spare the posterior membranous wall. The clinical presentation of TO is variable and ranges from incidental diagnosis in asymptomatic patients during workup or management for unrelated medical problems, to devastating disease with central airway obstruction. Bronchoscopy remains the gold standard for diagnosing this condition. Radiographic studies play an important role in suggesting the diagnosis of TO and in the follow-up of this condition. The treatment of TO is usually symptomatic. with emphasis on the management and prevention of recurrent respiratory infections. Bronchoscopic or surgical treatment is usually reserved for symptomatic patients with severe airway narrowing and airflow obstruction.

Evidence for a distinctive pattern of bone formation in enthesophytes

Objectives:The mechanism of new bone formation at entheses in spondyloarthritis (SpA) is poorly understood, but it is a key factor contributing to disability in disease. As bony spur development is...

Concealed weapons: erectile claws in African frogs.

Vertebrate claws are used in a variety of important behaviours and are typically composed of a keratinous sheath overlying the terminal phalanx of a digit. Keratinous claws, however, are rare in living amphibians; their microstructure and other features indicate that they probably originated independently from those in amniotes. Here we show that certain African frogs have a different type of claw, used in defence, that is unique in design among living vertebrates and lacks a keratinous covering. These frogs have sectorial terminal phalanges on their hind feet that become functional by cutting through the skin. In the resting state, the phalanx is subdermal and attached to a distal bony nodule, a neomorphic skeletal element, via collagen-rich connective tissue. When erected, the claw breaks free from the nodule and pierces the ventral skin. The nodule, suspended by a sheath attached to the terminal phalanx and supported by collagenous connections to the dermis, remains fixed in place. While superficially resembling the shape of claws in other tetrapods, these are the only vertebrate claws known to pierce their way to functionality.

Dickkopf-1 is a master regulator of joint remodeling

Degenerative and inflammatory joint diseases lead to a destruction of the joint architecture. Whereas degenerative osteoarthritis results in the formation of new bone, rheumatoid arthritis leads to bone resorption. The molecular basis of these different patterns of joint disease is unknown. By inhibiting Dickkopf-1 (DKK-1), a regulatory molecule of the Wnt pathway, we were able to reverse the bone-destructive pattern of a mouse model of rheumatoid arthritis to the bone-forming pattern of osteoarthritis. In this way, no overall bone erosion resulted, although bony nodules, so-called osteophytes, did form. We identified tumor necrosis factor-alpha (TNF) as a key inducer of DKK-1 in the mouse inflammatory arthritis model and in human rheumatoid arthritis. These results suggest that the Wnt pathway is a key regulator of joint remodeling.

A Case of Extensive Hyperostosis Frontalis Interna in an 87‐year‐old, Female Human Cadaver

Hyperostosis frontalis interna (HFI) is a condition that involves thickening of the inner surface of the frontal bones with sparing of the midline. Little is known about the etiology and clinical presentation of HFI. We report unusual findings in the case of a woman with extensive hyperostosis of the frontal bones and a large hyperostotic nodule in the parietal bone with impingement on the precentral gyrus; separating it from the common form of HFI. The calvaria and brain were photographed, specimens of bone were paraffin embedded, and sections stained using the Von Kossa Method with MacNeal’s tetrachrome. Medical records were reviewed, and additional history obtained through interviews with the donor’s family. The calvaria showed extensive, bilateral thickening of frontal bones with irregular topography. A 3.5 cm bony nodule was visible on the inner table of the left parietal bone. The dura and cerebrum showed compression in this region. The dura was strongly adherent to hyperostotic areas. Microscopic analysis revealed that hyperostotic bone contained extensive remodeling of the compact bone of the endocranial plate to a spongy phenotype. Quantitative analysis of sections showed a lower proportion of lamellar bone (37.6–38.4%, frontal) than in the control (60.1%, unaffected parietal). This is an extensive case of Type D HFI with both frontal and parietal involvement, and a significantly larger proportion of spongy bone in affected regions. The patient exhibited several symptoms that have been previously correlated to HFI; we suggest that the HFI disease process was responsible for the manifestation of these symptoms.

Tracheopathia Osteoplastica Misdiagnosed as Asthma

Tracheopathia osteoplastica (TPO) is a rare disorder characterized by cartilaginous or bony mucosal nodules in the tracheobronchial tree. Due to most patients being asymptomatic, the majority are diagnosed post-mortem. If symptoms are present, they typically include chronic cough, dyspnea, hemoptysis, hoarseness, and wheezing, with some of these symptoms overlapping with asthma. This case report describes an adult female with chronic cough who was diagnosed with asthma that was refractory to therapy for 8 years. Computed tomography (CT) of the chest revealed several soft tissue masses in the trachea with bronchoscopy revealing TPO in the upper portion of the trachea. She was diagnosed with TPO and started on airway clearance and a nasal corticosteroid spray with resolution of the cough at follow-up 3 months later.

Tracheobronchopathia osteochondroplastica: A rare cause of tracheal stenosis—“TPO stenosis”

Tracheobronchopathia osteochondroplastica, or tracheopathia osteoplastica (TPO), is characterized by multiple cartilaginous or bony submucosal nodules that project into the tracheal and bronchial lumina and may or may not cause respiratory symptoms. The nodules always originate in airway cartilages and typically spare the posterior membranous wall.1

Tracheobronchopathia Osteochondroplastica

Tracheobronchopathia osteochondroplastica is characterized by multiple cartilaginous or bony submucosal nodules, which project into the tracheobronchial lumen sparing the posterior wall. The disease is manifested by chronic cough, wheezing, dyspnea, and hemoptysis. Even though roentgenologic imaging

Tracheobronchopathia osteochondroplastica presenting as an isolated nodule in the right upper lobe bronchus with upper lobe collapse

Tracheobronchopathia osteochondroplastica is a rare benign condition that is characterized by the presence of bony and cartilaginous nodules in the tracheal and bronchial mucosa. It was first described by Rokitansky (1855), Luschka (1856), and Wilks (1857). The cause of the disease still remains unknown. Most cases are asymptomatic and frequently diagnosed incidentally during routine bronchoscopies and occasionally during difficult intubations or radiologic examinations. Clinical Summary A 55-year-old woman presented with a history of dry cough and left-sided chest pain associated with low-grade fever of 6 months’ duration. She had been given a diagnosis of tuberculous cervical lymphadenitis 3 years previously and had received a course of antituberculous therapy. The general physical and systemic examination did not reveal any significant abnormality. The chest x-ray film showed no abnormalities. The laboratory profile, including sputum for acid-fast bacilli, was negative. Fiberoptic bronchoscopy showed normal tracheal mucosa with a sharp and mobile carina. The right upper lobe bronchus was completely occluded by a hard mass that was difficult to biopsy. The bronchoscopic biopsy report was inconclusive, and the cytology report was negative for malignancy. A computed tomographic scan of the thorax showed occlusion of the right upper lobe bronchus by a calcified mass with no parenchyma lextensio nan dcollaps eo fth elun gdistall y(Figur e1) .A right upper lobectomy was performed. There was an intraluminal tumor occluding the right upper lobe bronchus with an adequate stump available for closure after resection. The gross specimen revealed a hard, polypoid, whitish nodule measuring 1.0 cm in diameter that occluded the right upper lobe bronchus. The lung parenchyma appeared unremarkable. On microscopic examination, the bronchial wall at the site of the nodule showed a polypoidal lesion covered by bronchial epithelium and composed of cartilage and

Treatment of Severe Tracheobronchopathia Osteochondroplastica

Tracheobronchopathia osteochondroplastica (TBOP) is a rare benign tracheobronchial disease of unknown etiology. It is characterized by the presence of bony and/or cartilaginous nodules in the submucosal surface of the large airways. Most patients are asymptomatic. In symptomatic individuals, nodules usually cover the entire mucosal surface of the lumen except the posterior wall, and their fusion leads to obstruction of the lumen. Clinical presentation could include productive cough, dyspnea, hemoptysis, acute respiratory distress, and recurrent infections of the respiratory tract. Several therapeutic approaches, including laser ablation, mechanical debulking, and surgical resection of the involved airway, have been used in the past, but there are no specific guidelines for managing this disease. We present 2 cases of severe TBOP successfully managed in our interventional pulmonology suite. The goal of our intervention was to sculpt the airways to resemble their original anatomy. We achieved this by using a combination of rigid bronchoscopy, laser photocoagulation, mechanical debulking, and silicone stent placement.

Tracheopathia Osteochondroplastica

The case of a male, 61 years of age, presenting with occasional hemoptysis and shortness of breath (duration of 1 year) is reported. Congestive heart failure was presumed and supported by chest x-ray and echocardiography. The patient improved with diuretic and angiotensin converting enzyme (ACE) inhibitor therapy, but continued to experience cough and occasional hemoptysis. Bronchoscopy revealed numerous firm nodular projections within the trachea with distribution along the cartilaginous rings. Tracheopathia osteochondroplastica (TPO) was diagnosed. TPO is an uncommon, benign, but slowly progressive disease of unknown etiology. It is characterized by endoluminal projection of cartilaginous and bony nodules arising in the submucosa of the trachea. Involvement may extend to lobar or segmental bronchi. TPO should be considered in cases where cough, dyspnea, persistent pulmonary infection, hoarseness, or recurrent hemoptysis remain after appropriate treatment of other presumptive underlying causes.

Tracheobronchopathia Osteochondroplastica

Tracheobronchopathia osteochondroplastica (TPO) is an uncommon benign disease of unknown etiology characterized by multiple cartilaginous or bony submucosal nodules, which project into the tracheobronchial lumen. The nodules originate in the airway cartilages and thus typically spare the posterior membranous wall of the airways. The disorder is more common in men and the diagnosis is usually made in the fourth through sixth decades of life. There is no relationship to smoking or other systemic disorders. The disease is manifested by chronic cough and wheezing, which frequently lead to the mistaken diagnosis of asthma. Other pulmonary symptoms include dyspnea and hemoptysis. One of the complications is the increased incidence of recurrent respiratory infections. The pulmonary symptoms and complications are the consequence of narrowing and thickening of the airway walls. Even though roentgenologic imaging studies may indicate the diagnosis, bronchoscopy is the most definitive diagnostic test. The bronchoscopic appearance alone is diagnostic of the disease, and biopsy of the airway lesions is seldom, if ever, required. Although there is no specific therapy for this disorder, management of tracheobronchopathia osteochondroplastica includes bronchodilators, prompt treatment of pulmonary infections, and bronchoscopic dilatation when indicated.

One Case of Tracheopathia Osteoplastica

Tracheopathia osteoplastica is a rare, benign pathologic condition chahacterized the occurrence of numerous cartilage and bony nodules within the tissue of mucosa. We report a case of tracheopathia osteoplastica that involved both larynx and trachea. The patient was 73 years old male and had hoarseness. The neck CT showed thickened and irregular wall of the trachea extending to the level of the carina with multiple calcified nodules and plaques of bony density projecting into the lumen.

Illustrations of the effects of rheumatic gout or chronic rheumatic arthritis on all the articulations with descriptive and explanatory statements. 1857.

Illustrations of the effects of rheumatic gout or chronic rheumatic arthritis on all the articulations with descriptive and explanatory statements. 1857.

Spectrum of neurogenic tumors in the thorax: CT and pathologic findings.

Neurilemomas and neurofibromas appear as round soft tissue masses at CT. Variable enhancement with either homogeneity or heterogeneity is seen in neurilemomas. Attenuation of the tumors on enhanced CT depends on histology: the extent of Antoni A or B tissue and the amount of myxoid or cystic degeneration or hemorrhage. Neurofibromas are usually homogeneous low attenuation lesions on unenhanced CT. They show homogeneous enhancement or early central blush on enhanced scan. The extent of enhancement depends on the proportions of tumor components: nerve sheath cells, collagen bundles, and areas of myxoid degeneration. Malignant nerve sheath tumors show variable attenuation. Bony destruction, pleural effusion, and metastatic pulmonary nodules may also occur. Ganglioneuromas appear as oblong homogeneous low attenuation lesions on both enhanced and unenhanced CT. This low attenuation is due to their pathologic components, with an abundant amount of myxoid matrices and a relatively small amount of ganglion cells. Neuroblastomas appear as aggressive soft tissue lesions with calcification. Ganglioneuroblastomas may appear with features in between those of ganglioneuromas and neuroblastomas. The typical location of the posterior mediastinum or the aortopulmonary window and high enhancement with administration of contrast medium at CT suggest the diagnosis of paragangliomas.

Trachéobronchopathie ostéochondroplastique: cinq observations

Five new cases of tracheobronchopathia osteochondroplastica (TBOCP) are reported and clinical, radiological and pathological features are reviewed. TBOCP is a rare disease characterized by cartilaginous and bony nodules lining the mucosa of the trachea and major bronchi. The endoscopic features realize pathological evolution by stadiums. The prognosis is usually favourable. The etiology of TBOCP remains unknown, even though some cases were reported in association with amyloidosis.

Multicentric Skeletal Sarcomas Associated with Probable Retrovirus Particles in Two African Hedgehogs (Atelerix albiventris)

Multicentric Skeletal Sarcomas Associated with Probable Retrovirus Particles in Two African Hedgehogs (<i>Atelerix albiventris</i>)

Meckel's cartilage in the human embryo and fetus.

This work studied the development of the ventral part of Meckel's cartilage in a series of human embryos (classified in stages) and fetuses. These stages appeared particularly important: stage 16, appearance of Meckel's cartilage; stage 20, beginning of membranous ossification of mandible; and stage 23, end of the embryonic period (8th week). The primitive bony nodule which develops from the embryonic mesenchyme appears as a double bony layer forming a groove containing the neurovascular bundle, into which the dental lamina is also invaginated. It was concluded that during the fetal period, the cartilage participates in the formation of the body of the mandible in an area close to the mental foramen via endochondral ossification. The cartilage disappears in parallel with the development of ossification by the sixth month.

Relations between Meckel's cartilage and the morphogenesis of the mandible in the human embryo.

Based on a series of human embryos classified in stages, the authors studied the evolution of Meckel's cartilage in its ventral portion and its relations to the morphogenesis of the mandible. Three stages appeared particularly important: stage 16, appearance of Meckel's cartilage; stage 20, beginning of membranous ossification; and stage 23, end of the embryonic period (8th week). The primitive bony nodule which develops from the embryonic mesenchyme appears as a double bony layer forming a groove containing the neurovascular bundle, into which the dental lamina is also invaginated.

舌に発生した骨性分離腫の１例

Lingual osseous choristoma is a rare lesion. We describe a case of lingual osseous choristoma in a 23 year old female. The lesion appeared as a pedunculated mass measuring about 4×4×8 mm, near the foramen caecum of the tongue. The mass was excised under general anesthesia. Histologically this lesion consisted of a well circumscribed mass of dense lamellar bone with Haversian canals. The bony nodule was bordered by a narrow band of dense fibrous tissue, and covered with squarnous mucosa. The excised area of the tongue was healed and free of recurrence one year later.