Incidental Detection of Tracheobronchopathia Osteochondroplastica During a Bronchoscopy in a Patient With Papillary...

Tracheobronchopathia osteochondroplastica (TPO) is a rare, benign condition characterized by submucosal osseocartilaginous nodules sparing the posterior tracheal wall. We report a unique case of a 45-year-old male with a history of smoking, gastroesophageal reflux disease (GERD), and papillary thyroid carcinoma, in whom TPO was incidentally discovered during intraoperative bronchoscopy for hemithyroidectomy. The patient was asymptomatic from a respiratory standpoint, but bronchoalveolar lavage identified Streptococcus pneumoniae and methicillin-resistant Staphylococcus aureus (MRSA), suggesting a possible role of chronic infection in TPO pathogenesis. Diagnosis was confirmed through imaging and histopathology, revealing typical tracheal nodularity with no airway obstruction. No specific treatment was required for TPO, and the patient was managed conservatively with antibiotics for airway colonization. This case highlights the importance of recognizing TPO during unrelated procedures to avoid misdiagnosis and supports the hypothesis of infection-driven chronic inflammation contributing to its development.