Tracheobronchopathia Osteochondroplastica Presenting as Acute Shortness of Breath




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An outpatient case of tracheobronchopathia osteochondroplastica is reported in a 58-year-old male presenting from the Dallas-Fort Worth area. Tracheobronchopathia osteochondroplastica (TO) is an exceedingly rare, non-neoplastic tracheobronchial condition characterized by multitudinous sessile, cartilaginous nodules, most prominent along the anterolateral walls and projecting into the lumen of the trachea and bronchi (Silveira et al 2017). Here we highlight the case of a middle-aged male presenting to the outpatient clinic with acute shortness of breath and cough. Chest CT without contrast was promptly ordered, displaying anterior and lateral endotracheal submucosal nodularity. Subsequent bronchoscopy confirmed the diagnosis of TO. Diagnosis and management of this condition is limited by clinicians' lack of familiarity with this pathology. Unfortunately, because of its rarity and potentially broad array of presenting symptoms, diagnosis may often be delayed resulting in increased stress for the expectant patient. The time between first symptoms and ultimate diagnosis is about 4 years in most cases; however, can be greater than 25 years according to some reports (Jabbardarjani et al 2008). Radiographically, tracheobronchopathia osteochondroplastica can look similar to other conditions in the trachea such as relapsing polychondritis, granulomatous processes such as granulomatosis with polyangiitis, and sarcoidosis. Amyloidosis, inflammatory bowel disease, and certain infectious processes should be considered as well. As such, the purpose of this case report is to increase clinical awareness of this rare condition to potentially expedite its management and diagnosis.