Eksombatchai Dararat, Boonsarngsuk Viboon, Amornputtisathaporn Naparat, Suwatanapongched Thitiporn, Kurimoto Noriaki
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Thailand.
Intern Med. 2013;52(7):801-5. doi: 10.2169/internalmedicine.52.9416. Epub 2013 Apr 1.
Respiratory tract chondritis is not uncommon in patients with relapsing polychondritis (RP); however, diagnosing this condition remains problematic, especially in patients whose extrapulmonary manifestations do not predominate, as there are broad differential diagnoses of airway obstruction. We herein report the case of a 56-year-old man who presented with cough and dyspnea. Computed tomography of the chest demonstrated diffuse smooth thickening of the visualized tracheobronchial wall with a moderately narrowed lumen. Airway chondritis was diagnosed on endobronchial ultrasound following demonstration of thickening of the submucosal and cartilaginous layers in the anterior and lateral aspects of the bronchial wall, while the posterior region expressed less involvement. In conjunction with nasal and auricular chondritis, which were previously overlooked, RP was finally diagnosed.
呼吸道软骨炎在复发性多软骨炎（RP）患者中并不少见；然而，诊断这种疾病仍然存在问题，尤其是在肺外表现不突出的患者中，因为气道阻塞的鉴别诊断范围很广。我们在此报告一例56岁男性患者，其表现为咳嗽和呼吸困难。胸部计算机断层扫描显示可见的气管支气管壁弥漫性光滑增厚，管腔中度狭窄。在支气管壁前侧和外侧的粘膜下层和软骨层增厚得到证实后，经支气管内超声诊断为气道软骨炎，而后侧区域受累较少。结合之前被忽视的鼻和耳软骨炎，最终诊断为RP。
