1986 Volume 8 Issue 2 Pages 274-278
Two cases of tracheobronchopathia osteochondroplastica are described. Case 1. A 30 year-old man experienced duodenal ulcer two months prior to admission to our hospital. He gave a history of a suffocating feeling for over 2 years. Laboratory tests on admission showed a high level of lgM (301mg/dl) and low level of lgG (837mg/dl). At bronchofiberscopy a large number of hard, nodules and plaque were seen in the anterolateral wall of the trachea. The posterior membranous portion of the trachea was normal. Histologic examination of biopsy specimens from right B^6 showed cartilagenous tissue with marked calcification under the superficial respiratory epithelium. A bony nodule was also found in the other specimen. Case 2. A 47 year-old woman had a history of chronic sinitis for over 24 years, and had experienced lung tuberculosis 22 years prior to the present admission. She suffered from persistent cough for over 17 years, and she was admitted to our hospital with a complaint of recurrent episodes of hemoptysis. There was no significant finding in the laboratory data. Bronchofiberscopy revealed numerous hard nodules and plaque in the trachea and major bronchi, but the posterior membranous trachea was normal. Biopsy specimens from the right main bronchus showed squamous metaplasia with chronic inflammatory cell infiltration and hyaline cartilages under the superficial respiratory epithelium. The other specimen showed bony tissue and fatty marrow formation. Tracheobronchopathia osteochondroplastica is a rare disease with accumulation of bony and cartilagenous nodules in the tracheal and major bronchial mucosa. The disease was first described by Rokitanski in 1855, and Wilks in 1857. Until 1985, only 44 cases of tracheobronchopathia osteochondroplastica had been reported in Japan. Although the etiology of the disease is unknown, chronic inflammation may be directly or indirectly involved.
