Cho Hyun Kyu, Jeong Byeong-Ho, Kim Hojoong
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
J Thorac Dis. 2020 Oct;12(10):5571-5579. doi: 10.21037/jtd-20-1898.
Tracheobronchopathia osteochondroplastica (TPO) is characterized by the presence of diffuse cartilaginous or bony submucosal nodules that lead to airway lumen narrowing. So far, there was no study in South Korea analysing a large number of TPO patients. We aimed to elucidate its treatment strategy and clinical course by analysing the characteristics of TPO patients.
In this retrospective study, we reviewed the clinical data of 40 patients diagnosed with TPO by bronchoscopy between October 1997 and April 2019 at a single referral hospital.
Of the 40 patients, 26 (65.0%) were male and the median age was 63.0 years. The most common symptom was cough (n=12, 30%). Pulmonary function test (PFT) revealed an obstructive pattern in 10 (25.7%) patients. Chest computed tomography (CT) scan showed 23 (62.6%) patients with diffuse narrowing and calcified nodules. In bronchoscopy, the entire trachea was found to be involved in 30 (75.0%) patients and airway narrowing was identified in 6 (15.0%) patients. Endobronchial biopsies were obtained from 15 patients and the most common findings included typical cartilaginous and bony tissues (n=14, 93.3%). Since most patients were asymptomatic or had mild symptoms, they did not undergo any specific treatment. Of the 19 symptomatic patients, 2 (5.0%) patients received laser therapy for treating tracheal stenosis.
TPO is a slowly progressing disease and is well managed with conservative therapies. Although TPO shows a distinctive pattern by bronchoscopy, it follows a benign clinical course.
气管支气管骨软骨化生(TPO)的特征是存在弥漫性软骨或骨性黏膜下结节,导致气道管腔狭窄。到目前为止,韩国尚无分析大量TPO患者的研究。我们旨在通过分析TPO患者的特征来阐明其治疗策略和临床病程。
在这项回顾性研究中,我们回顾了1997年10月至2019年4月期间在一家转诊医院通过支气管镜诊断为TPO的40例患者的临床资料。
40例患者中,26例(65.0%)为男性,中位年龄为63.0岁。最常见的症状是咳嗽(n = 12,30%)。肺功能测试(PFT)显示10例(25.7%)患者存在阻塞性模式。胸部计算机断层扫描(CT)显示23例(62.6%)患者有弥漫性狭窄和钙化结节。在支气管镜检查中,发现30例(75.0%)患者的整个气管均受累,6例(15.0%)患者存在气道狭窄。对15例患者进行了支气管内活检,最常见的发现包括典型的软骨和骨组织(n = 14,93.3%)。由于大多数患者无症状或症状轻微,他们未接受任何特殊治疗。在19例有症状的患者中,2例(5.0%)患者接受了激光治疗以治疗气管狭窄。
TPO是一种进展缓慢的疾病,采用保守治疗可得到良好控制。尽管TPO在支气管镜检查中表现出独特的模式,但其临床病程呈良性。