Aktas T, Aktas F, Ozmen Z, Yaşayancan N, Arıcı A
Department of Pulmonary Diseases, Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey.
Department of Radiodiagnostics, Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey.
Niger J Clin Pract. 2017 Apr;20(4):495-497. doi: 10.4103/1119-3077.204373.
Tracheobroncopathia osteochondroplastica (TO) is a benign disease of the large airways seen very rarely. It is characterized by 1-3 mm sized ossified nodular lesions in submucosa. Its etiology is unclear, but it is stated that malignancy, chronic inflammation, amyloidosis, and genetic factors might have an effect on it. It was first described by Wilks in a 38-year-old man diagnosed with tuberculosis in 1857. Generally, patients are asymptomatic and TO is diagnosed incidentally. But symptoms become significant with infections and obstruction in tracheabronchial tree. Generally chest radiography is normal, so thorax computed tomography can be remarkable in diagnosis of TO. Besides, final diagnosis can be established by viewing ossified nodules in trachea and bronchus through the fiberoptic bronchoscopy. Amyloidosis, tuberculosis, sarcoidosis, bronchial carcinoma, and tracheobronchial calcinosis must be remembered in differential diagnosis. Also ossifications in submucosa and proof of bone marrow in histopathological examinations are important in diagnosis of TO. Mostly palliative treatment is performed to the symptoms . We want the clinicians to keep in mind for this very rarely seen tracheal disease with three case reports.
气管支气管骨软骨化生(TO)是一种非常罕见的大气道良性疾病。其特征是黏膜下出现大小为1 - 3毫米的骨化结节性病变。其病因尚不清楚,但有观点认为恶性肿瘤、慢性炎症、淀粉样变性和遗传因素可能对其有影响。1857年,威尔克斯首次在一名38岁被诊断为肺结核的男性患者中描述了该病。一般来说,患者无症状,TO多为偶然发现。但随着气管支气管树的感染和阻塞,症状会变得明显。通常胸部X线检查正常,因此胸部计算机断层扫描在TO的诊断中可能具有重要意义。此外,通过纤维支气管镜观察气管和支气管内的骨化结节可确立最终诊断。鉴别诊断时必须考虑淀粉样变性、肺结核、结节病、支气管癌和气管支气管钙化。此外,黏膜下骨化以及组织病理学检查中骨髓的证据在TO的诊断中也很重要。对于症状大多采取姑息治疗。通过三例病例报告,我们希望临床医生记住这种非常罕见的气管疾病。