Tuberc Respir Dis.  2008 Feb;64(2):144-148.

A Case of Tracheomegaly and Recurrent Pneumomediastinum Combined with Pulmonary Fibrosis

Affiliations
  • 1Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, Korea. uhs@hosp.sch.ac.kr

Abstract

Tracheomegaly is a distinctive condition that presents with marked dilation of the trachea. Spontaneous pneumomediastinum is the result of alveolar rupture with dissection of the airway along the bronchus and into the mediastinum. Tracheomegaly and recurrent spontaneous pneumomediastinum are rare complications of pulmonary fibrosis when combined with rheumatoid arthritis. We present a case of tracheomegaly and recurrent spontaneous pneumomediastinum that was precipitated by repeated respiratory infection and chronic cough in a patient with pulmonary fibrosis that was associated with rheumatoid arthritis.

Keyword

Tracheomegaly; Recurrent pneumomediastinum; Pulmonary fibrosis

MeSH Terms

Arthritis, Rheumatoid
Bronchi
Cough
Humans
Mediastinal Emphysema
Mediastinum
Pulmonary Fibrosis
Rupture
Trachea

Figure

  • Figure 1 Chest PA and HRCT (high resolution computerized tomography) of lung at one year ago (A, B) and admission (C, D). At admission, chest PA shows more dilated diameter of trachea (26.5 mm, thick arrow, C) compared to that of chest PA one year ago (19.7 mm, A). Furthermore, linear radiolucent density is observed along with right mediastinum suggesting pneumomediastinum (thin arrow, C) which is not observed at one ago (A). HRCT shows more aggravated diffuse peripheral and lower lung reticulation and honeycombing (B) compared to that of HRCT at one year ago (D).

  • Figure 2 Chest CT scan at one year ago (A), 4 months ago (B), and at admission (C). Chest CT scan taken one year ago shows normal luminal diameter of the trachea and no pneumomediastium (A). As compared with A, chest CT scan taken 4 months ago (B) shows more enlarged trachea and small amount of mediastinal air surrounding the trachea. At admission, chest CT scan (C) shows prominent dilatation of trachea and large amount of recurrent pneumomediastinum.


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