Pebbled Trachea

Abstract

We report a series of three cases diagnosed with tracheobronchopathia osteochondroplastica on bronchoscopy and computed tomography (CT) chest. Most patients were diagnosed incidentally on evaluation for chronic cough. The association of this entity with chronic bacterial infections and tuberculosis is an intriguing entity that was observed in our patients. Nodular, ulcerative, and calcific lesions in the trachea are bronchoscopic findings seen in quite a few other conditions posing diagnostic challenges. However, the classical bronchoscopic appearance with CT imaging in an appropriate clinical context can lead to an accurate diagnosis of this condition. We describe this array of cases with varying clinical presentations, their associations, and deliberate the literature reviews on this rare entity.

Impact of Tracheobronchopathia Osteochondroplastica on Difficult Intubation

“… 2 , 3 CT findings characteristic of TPO include nodular submucosal calcifications sparing the posterior tracheal wall. 2 , 3 , 5 In our patient, concurrent nasal pathology with elevated c‐ANCA titers suggests that additional manifestations of TPO may exist and is an important consideration during surgical planning to avoid morbidity and mortality. 4 In non‐emergent cases during elective procedures, maintenance of spontaneous ventilation and patient emergence from anesthesia should be a priority when considering possible TPO.…”

“…Diagnosis of TPO can be made by CT or bronchoscopy, yet is often incidentally found during intubation, or during autopsy 2,3 . CT findings characteristic of TPO include nodular submucosal calcifications sparing the posterior tracheal wall 2,3,5 . In our patient, concurrent nasal pathology with elevated c‐ANCA titers suggests that additional manifestations of TPO may exist and is an important consideration during surgical planning to avoid morbidity and mortality 4 .…”

Building and validating an artificial intelligence model to identify tracheobronchopathia osteochondroplastica by using bronchoscopic images

“… 3 Although TO is rare, there have been many reports in which it was occasionally diagnosed. 1 , 4 – 27 To date, only a limited number of studies have utilized extensive data to conduct a comprehensive investigation of this disease. 3 , 28 …”