Multi-nodule of large airway: tracheobronchopathia osteochondroplastica

Tracheobronchopathia osteochondroplastica (TO) is a benign rare disease characterized by multiple tracheobronchial nodules, which has not been clearly illuminated and there are no standard guidelines for TO management. The aim of this study was to clarify the clinical features and treatment outcomes of TO and provide basis for clinical diagnosis and treatment.

A total of 32,215 patients taken bronchoscopy were retrospectively reviewed to select patients diagnosed with TO. Clinical characteristics, bronchoscopic manifestations, CT images, histopathological features, treatments and clinical course were investigated.

13 male and 6 female were identified as TO. The average age was 47.42±12.12 years. The incidence rate of TO in our study by bronchoscopy was 0.06%. The most frequent manifestation was chronic cough. Based on bronchoscopic manifestations, patients were categorized as three groups: the largest proportion was group of Stage II (10/19), followed by Stage III (5/19) and Stage I (4/19). The positive rate of CT in stage I, stage II and stage III was 0%, 50%, 100%, respectively. Histopathological analysis presented inflammatory exudation, squamous metaplasia, submucosal cartilaginous and osseous deposition. Bronchoscopic intervention and inhaled corticosteroids were administered to subjects in stage II and III, which improved their life qualities to some degree.

Not only multi-disciplinary cooperation of clinical, endoscopic and histological assessment, but also awareness are crucial to TO diagnosis, especially in early stage of TO, which was difficult to identify. The stage of TO based on bronchoscopic visualization might be applied to guide the choice of clinical treatment strategy.