Tuberc Respir Dis.  2008 Sep;65(3):235-238.

Tracheopathia Osteochondroplastica with Recurrent Massive Hemoptysis and Atelectasis: A Case Report

Affiliations
  • 1Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea. droij@chonnam.ac.kr
  • 2Department of Pathology, Chonnam National University Medical School, Gwangju, Korea.

Abstract

We treated a rare case of TO that presented with recurrent massive hemoptysis that resulted in total obstruction of the bronchus intermedius by very large blood clots. Bronchoscopic intervention resulted in a full recovery from the atelectasis. However, there are no guidelines for preventing recurrence of the hemoptysis or disease progression. Conservative and expectant management are used to treat these patients and most do well.

Keyword

Tracheopathia osteochondroplastica; Massive hemoptysis; Atelectasis

MeSH Terms

Bronchi
Disease Progression
Hemoptysis
Humans
Pulmonary Atelectasis
Recurrence

Figure

  • Figure 1 (A) The initial chest radiograph shows atelectasis of the right middle and lower lobes. The coronal (B) and sagittal (C) reformatted images of the precontrast CT shows diffuse multiple fine nodularity and calcifications along the anterolateral tracheal and both main bronchial walls (arrows) with sparing of the posterior tracheal wall of (arrowheads) and hemorrhage in the right bronchus intermedius (star) with distal obstructive atelectasis.

  • Figure 2 The bronchoscopic findings show (A, B) multiple fine nodules in the artilaginous tracheal wall from just below vocal cord to 2 cm above carina with (C) total obstruction of the right bronchus intermedius by (D) a very large blood clot; bronchoscopic removal of the clot was performed.

  • Figure 3 The pathologic findings showed a submuosal nodule with metaplastic bone and cartilage (H&E stain, x40).

  • Figure 4 Virtual CT bronchoscope image also shows multiple small irregular nodules along the anterolateral wall of the trachea (arrows) with preservation of the posterior wall (P).


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