Tracheobronchopathia osteochondroplastica
Tracheobronchopathia Osteochondroplastica (TO) is a rare disease characterized by the presence of multiple, hard, nodular growths that primarily develop on the anterior and lateral walls of the trachea and large bronchi. These growths are made of bone and cartilage, and they do not affect the posterior membranous wall of the trachea. The condition is benign and often discovered incidentally during bronchoscopy or imaging studies for unrelated reasons. The exact cause of TO is unknown, and it is considered a rare condition with only a few hundred reported cases in medical literature.
Symptoms and Diagnosis[edit | edit source]
The majority of individuals with TO are asymptomatic, but when symptoms do occur, they can include chronic cough, dyspnea (difficulty breathing), wheezing, recurrent respiratory infections, and hemoptysis (coughing up blood). Symptoms are often attributed to other more common respiratory conditions, which can delay diagnosis.
Diagnosis of TO is primarily made through bronchoscopy, where the characteristic nodules can be directly visualized. Computed tomography (CT) scans of the chest can also suggest the diagnosis by showing irregularities along the tracheal and bronchial walls, but bronchoscopy is necessary for confirmation. Histological examination of biopsy samples can differentiate TO from other conditions by revealing the presence of bone and cartilage within the nodules.
Treatment[edit | edit source]
There is no cure for TO, and treatment is usually symptomatic. Management strategies may include physiotherapy to aid in the clearance of secretions, antibiotics for respiratory infections, and in severe cases, surgical interventions such as laser ablation or mechanical debulking of the nodules to relieve airway obstruction. However, these invasive procedures are reserved for individuals with significant symptoms or compromised airway patency.
Epidemiology[edit | edit source]
TO is a rare condition with an unknown prevalence. It has been reported in adults of all ages but is most commonly diagnosed in middle-aged and elderly individuals. There is no clear gender predilection. The etiology of TO remains unclear, but it is not believed to be hereditary or associated with smoking, unlike many other respiratory conditions.
Prognosis[edit | edit source]
The prognosis for individuals with TO is generally good, as the disease tends to progress slowly and does not transform into malignancy. However, the quality of life can be affected in symptomatic individuals due to chronic respiratory symptoms. Regular follow-up with a pulmonologist is recommended to monitor the progression of the disease and manage symptoms effectively.
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Contributors: Prab R. Tumpati, MD