Download PDF
Semin Respir Crit Care Med 2002; 23(2): 167-176
DOI: 10.1055/s-2002-25305
Copyright © 2002 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Tracheobronchopathia Osteochondroplastica

Udaya B.S. Prakash
  • Pulmonary, Critical Care, and Internal Medicine, Mayo Medical School and Mayo Medical Center, Rochester, Minnesota
Further Information

Publication History

Publication Date:
24 April 2002 (online)

    Permissions and Reprints

ABSTRACT

Tracheobronchopathia osteochondroplastica (TPO) is an uncommon benign disease of unknown etiology characterized by multiple cartilaginous or bony submucosal nodules, which project into the tracheobronchial lumen. The nodules originate in the airway cartilages and thus typically spare the posterior membranous wall of the airways. The disorder is more common in men and the diagnosis is usually made in the fourth through sixth decades of life. There is no relationship to smoking or other systemic disorders. The disease is manifested by chronic cough and wheezing, which frequently lead to the mistaken diagnosis of asthma. Other pulmonary symptoms include dyspnea and hemoptysis. One of the complications is the increased incidence of recurrent respiratory infections. The pulmonary symptoms and complications are the consequence of narrowing and thickening of the airway walls. Even though roentgenologic imaging studies may indicate the diagnosis, bronchoscopy is the most definitive diagnostic test. The bronchoscopic appearance alone is diagnostic of the disease, and biopsy of the airway lesions is seldom, if ever, required. Although there is no specific therapy for this disorder, management of tracheobronchopathia osteochondroplastica includes bronchodilators, prompt treatment of pulmonary infections, and bronchoscopic dilatation when indicated.

KEYWORD

Amyloidosis - airway disease - airway cartilage - bronchoscopy - obstructive airway disease - tracheobronchopathia osteochondroplastica - tracheopathia osteoplastica

REFERENCES

  • 1 Nienhuis D, Prakash U, Edell E. Tracheobronchopathia osteochondroplastica.  Ann Otol Rhinol Laryngol . 1990;  99 689-694
    PubMedGoogle Scholar
  • 2 Prakash U BS. What is tracheo(broncho)pathia osteo(chondro)plastica?.  J Bronchol . 2001;  8 75-77
    PubMedGoogle Scholar
  • 3 Prakash U, McCullough A, Edell E, Nienhuis D. Tracheopathia osteoplastica: familial occurrence.  Mayo Clin Proc . 1989;  64 1091-1096
    PubMedGoogle Scholar
  • 4 Bottles K, Nyberg D, Clark M, Hinchcliffe W. CT Diagnosis of tracheobronchopathia osteochondroplastica.  J Comput Assist Tomogr . 1983;  7 324-327
    PubMedGoogle Scholar
  • 5 Dalgaard J. Tracheopathia chondro-osteoplastica: a case elucidating the problems concerning development and ossification of elastic cartilage.  Acta Pathol Microbiol Scand . 1947;  24 118-134
    PubMedGoogle Scholar
  • 6 Moersch H J, Broders A C, Havens F Z. Tracheopathia osteoplastica (osteoma of the trachea).  Arch Otolaryngol . 1937;  26 291-293
    PubMedGoogle Scholar
  • 7 Wilks S. Ossific deposits on the larynx, trachea and bronchi.  Trans Pathol Soc Lond . 1857;  8 88
    PubMedGoogle Scholar
  • 8 Muckleston H. On so-called ``multiple osteomata'' of the tracheal mucous membrane.  Laryngoscope . 1909;  19 881-893
    PubMedGoogle Scholar
  • 9 Martin C. Tracheobronchopathia osteochondroplastica.  Arch Otolaryngol . 1974;  100 290-293
    PubMedGoogle Scholar
  • 10 Pedersen M, Worsoe-Petersen J. Tracheopathia osteoplastica.  J Laryngol Otol . 1969;  83 883-888
    PubMedGoogle Scholar
  • 11 Pounder D, Pieterse A. Tracheopathia osteoplastica: report of four cases.  Pathology . 1982;  14 429-433
    PubMedGoogle Scholar
  • 12 Smith D, Pillai R, Gillbe C. Tracheopathia osteplastica: a cause of unexpected difficulty in tracheal intubation.  Anaesthesia . 1987;  42 536-538
    PubMedGoogle Scholar
  • 13 Primer G. Tracheobronchopathia osteochondroplastica.  Prax Klin Pneumol . 1979;  33 1060-1063
    PubMedGoogle Scholar
  • 14 Bubash L A, Prakash U BS, Olsen K D. Tracheobronchopathia osteochondroplastica (unpublished data). 
    PubMedGoogle Scholar
  • 15 Vilkman S, Keistinen T. Tracheobronchopathia osteochondroplastica: report of a young man with severe disease and retrospective review of 18 cases.  Respiration . 1995;  62 151-154
    PubMedGoogle Scholar
  • 16 Eimind K. Tracheopathia chondro-osteoplastica.  Nord Med . 1964;  72 1029-1031
    PubMedGoogle Scholar
  • 17 Bioque J C, Feu N, Rubio J M. Tracheobronchopathia osteochondroplastica: clinical study and follow-up in nine cases.  J Bronchol . 2001;  8 78-83
    PubMedGoogle Scholar
  • 18 Baird R B, McCartney J N. Tracheopathia osteoplastica.  Thorax . 1966;  21 321-324
    PubMedGoogle Scholar
  • 19 Campbell A H, Gauld D R. Tracheopathia osteoplastica.  Med J Aust . 1968;  1 596
    PubMedGoogle Scholar
  • 20 Van Nieropp A M M, Wagenaar S S, van den Bosch M M J, Westermann C JJ. Tracheobronchopathia osteochondroplastica.  Eur J Resp Dis . 1983;  64 129-133
    PubMedGoogle Scholar
  • 21 Way S PB. Tracheopathia osteoplastica.  J Clin Pathol . 1967;  20 814-820
    PubMedGoogle Scholar
  • 22 Secrest P, Kendig T, Beland A. Tracheobronchopathia osteochondroplastica.  Am J Med . 1964;  36 815-818
    CrossrefPubMedGoogle Scholar
  • 23 Mariotta S, Pallone G, Pedicelli G, Bisetti A. Spiral CT and endoscopic findings in a case of tracheobronchopathia osteochondroplastica.  J Comput Assist Tomogr . 1997;  21 418-420
    CrossrefPubMedGoogle Scholar
  • 24 Jepsen O, Sorensen H. Tracheopathia osteoplastica and ozaena.  Acta Otolaryngol . 1960;  51 79-83
    PubMedGoogle Scholar
  • 25 Alroy G, Lichtig C, Kaftori J. Tracheobronchopathia osteochondroplastica: end stage of primary lung amyloidosis?.  Chest . 1972;  61 465-468
    PubMedGoogle Scholar
  • 26 Sakula A. Tracheobronchopathia osteochondroplastica: its relationship to primary tracheobronchial amyloidosis.  Thorax . 1968;  23 105-110
    PubMedGoogle Scholar
  • 27 Baugnee P E, Delaunois L M. Mycobacterium avium-intracellulare associated with tracheobronchopathia osteochondroplastica.  Eur Respir J . 1995;  8 180-182
    CrossrefPubMedGoogle Scholar
  • 28 Toyoda M, Ebihara Y, Kato H, Kita S. Tracheobronchial AL amyloidosis: histologic, immunohistochemical, ultrastructural, and immunoelectron microscopic observations.  Human Pathol . 1993;  24 970-976
    PubMedGoogle Scholar
  • 29 Shih J Y, Hsueh P R, Chang Y L. Tracheal botryomycosis in a patient with tracheopathia osteochondroplastica.  Thorax . 1998;  53 73-75
    PubMedGoogle Scholar
  • 30 Harma R, Suurkari S. Tracheopathia condro-osteoplastica: a clinical study of thirty cases.  Acta Otolaryngol . 1977;  84 118-123
    PubMedGoogle Scholar
  • 31 Vaheri E, Vaheri E. Tracheopathia osteoplastica.  Acta Otolaryngol . 1967;  64 251-255
    PubMedGoogle Scholar
  • 32 de Wall N, Roggenbuck C, Endres P, Hau T. Tracheobronchopathia osteochondroplastica and coexistent mucoepidermoid carcinoma of the lung: case report.  Pneumologie . 1992;  46 74-77
    PubMedGoogle Scholar
  • 33 Karlikaya C, Yuksel M, Kilicli S, Candan L. Tracheobronchopathia osteochondroplastica.  Respirology . 2000;  5 377-380
    CrossrefPubMedGoogle Scholar
  • 34 Morita S, Yokoyama N, Yamashita S, Izumi M, Kanda T, Nagataki S. Tracheopathia osteochondroplastica complicated with thyroid cancer: case report and review of the literature in Japan.  Japan J Med . 1990;  29 637-641
    PubMedGoogle Scholar
  • 35 Braman S S, Grillo H C, Mark E J. Weekly clinicopathological exercises: case 32-1999; a 44-year-old man with tracheal narrowing and respiratory stridor.  N Eng J Med . 1999;  341 1291-1300
    PubMedGoogle Scholar
  • 36 Shuttleworth J S, Self C L, Pershing H S. Tracheopathia osteoplastica.  Ann Intern Med . 1960;  52 234-242
    PubMedGoogle Scholar
  • 37 Weiss L. Isolated multiple nodular pulmonary amyloidosis.  Am J Clin Pathol . 1960;  33 318-329
    PubMedGoogle Scholar
  • 38 Phillips M J. Tracheopathia osteoplastica.  Proc R Soc Med . 1976;  69 358-359
    PubMedGoogle Scholar
  • 39 Capizzi S A, Betancourt E M, Prakash U BS. Tracheobronchial Amyloidosis.  Mayo Clin Proc . 2000;  75 1148-1152
    CrossrefPubMedGoogle Scholar
  • 40 O'Regan A, Fenlon H M, Beamis Jr F J, Steele M P, Skinner M, Berk J L. Tracheobronchial amyloidosis: the Boston University experience from 1984 to 1999.  Medicine . 2000;  79 69-79
    CrossrefPubMedGoogle Scholar
  • 41 Virchow R. Die krankhaften Geschwulste.  Berlin: Hirschwald 1883: 442-443
    Google Scholar
  • 42 Young R, Sandstrom R, Mark G. Tracheopathia osteoplastica: clinical, radiologic and pathologic correlations.  J Thorac Cardiovasc Surg . 1980;  79 537-541
    PubMedGoogle Scholar
  • 43 Aschoff-Freiburg L. Ueber Tracheopathia Osteoplastica.  Verh Dtsch Pathol . 1910;  14 125-127
    PubMedGoogle Scholar
  • 44 Way S. Tracheopathia osteoplastica.  J Clin Pathol . 1967;  20 814-820
    PubMedGoogle Scholar
  • 45 Bowen D. Tracheopathia osteoplastica.  J Clin Pathol . 1959;  12 435-439
    PubMedGoogle Scholar
  • 46 Tajima K, Yamakawa M, Katagiri T, Sasaki H. Immunohistochemical detection of bone morphogenetic protein-2 and transforming growth factor beta-1 in tracheopathia osteochondroplastica.  Virchows Archiv . 1997;  431 359-363
    CrossrefPubMedGoogle Scholar
  • 47 Clerf L H. Tracheopathia osteoplastica (osteoma of the trachea): report of a case.  Ann Otol Rhinol Laryngol . 1944;  53 839-843
    PubMedGoogle Scholar
  • 48 Lundgren R, Stjernberg N. Tracheobronchopathia osteochondroplastica: a clinical, bronchoscopic and spirometric study.  Chest . 1981;  80 706-709
    PubMedGoogle Scholar
  • 49 Molloy A R, McMahon J N. Rapid progression of tracheal stenosis associated with tracheopathia osteo-chondroplastica.  Intensive Care Med . 1988;  15 60-62
    PubMedGoogle Scholar
  • 50 Park S S, Shin D H, Lee D H, Jeon S C, Lee J H, Lee J D. Tracheopathia osteoplastica simulating asthmatic symptoms: diagnosis by bronchoscopy and computerized tomography.  Respiration . 1995;  62 43-45
    PubMedGoogle Scholar
  • 51 Marchesani F, Staccioli D, Pela R, Ranaldi R, Cecarini L, Sanguinetti C M. Tracheobronchopathia osteochondroplastica.  Monaldi Arch Chest Dis . 1993;  48 210-212
    PubMedGoogle Scholar
  • 52 Howland W J, Good C. The radiographic features of tracheopathia osteoplastica.  Radiology . 1958;  71 847-850
    PubMedGoogle Scholar
  • 53 Bergeron D, Cormier Y, Desmeules M. Tracheobronchopathia osteochondroplastica.  Am Rev Respir Dis . 1976;  114 803-806
    PubMedGoogle Scholar
  • 54 Clee M, Anderson J, Johnston R. Clinical aspects of tracheobronchopathia osteochondroplastica.  Br J Dis Chest . 1983;  77 308-314
    PubMedGoogle Scholar
  • 55 Meyer C N, Dossing M, Broholm H. Tracheobronchopathia osteochondroplastica.  Respir Med . 1997;  91 499-502
    PubMedGoogle Scholar
  • 56 Pieri J, Casalonga J. Chondromatose diffuse de la trachee et des bronches.  Presse Med . 1957;  65 1933-1935
    PubMedGoogle Scholar
  • 57 Onitsuka H, Hirose N, Watanabe K. Computed tomography of tracheopathia osteoplastica.  Am J Roentgenol . 1983;  140 268-270
    PubMedGoogle Scholar
  • 58 Castella J, Puzo C, Cornudella R, Curell R, Tarres J. Tracheobronchopathia osteochondroplastica.  Respiration . 1981;  42 129-134
    PubMedGoogle Scholar
  • 59 Hirsch M, Tovi F, Goldstein J, Gerzof S. Diagnosis of tracheopathia osteoplastica by computed tomography.  Ann Otol Rhinol Laryngol . 1985;  94 217-219
    PubMedGoogle Scholar
  • 60 Pounder D, Pieterse A. Tracheopathia osteoplastica: a study of the minimal lesion.  J Pathol . 1982;  138 235-239
    PubMedGoogle Scholar
  • 61 Coetmeur D, Bovyn G, Leroux P, Niel-Duriez M. Tracheobronchopathia osteochondroplastica presenting at the time of a difficult intubation.  Respir Med . 1997;  91 496-498
    PubMedGoogle Scholar
  • 62 Birzgalis A, Farrington W, O'Keefe L, Shaw J. Localized tracheopathia osteoplastica of the subglottis.  J Laryngol Otol . 1993;  107 352-353
    PubMedGoogle Scholar
  • 63 Thomas D, Stonell C, Hasan K. Tracheobronchopathia osteoplastica: incidental finding at tracheal intubation.  Br J Anaesth . 2001;  87 515-517
    CrossrefPubMedGoogle Scholar
  • 64 Tukiainen H, Torkko M, Terho E. Lung function in patients with tracheobronchopathia osteochondroplastica.  Eur Respir J . 1988;  1 632-635
    PubMedGoogle Scholar
  • 65 Magnusson P, Rotemark G. Tracheobronchopathia osteochondroplastica: three case reports.  J Laryngol Otol . 1974;  88 159-164
    PubMedGoogle Scholar
  • 66 Berend N, Harrison A C, Hartnett B J, Lawson J, Marlin G E. Tracheobronchopathia osteochondroplastica.  Austral New Zeal J Med . 1979;  9 188-192
    PubMedGoogle Scholar
  • 67 Whitehouse G. Tracheopathia osteoplastica.  Br J Radiol . 1968;  41 701-703
    PubMedGoogle Scholar
  • 68 Meyer C A, White C S. Cartilaginous disorders of the chest.  Radiographics . 1998;  18 1109-1123
    PubMedGoogle Scholar
  • 69 Williams S, Jones E. General case of the day: tracheobronchopathia osteochondroplastica.  Radiographics . 1997;  17 797-799
    PubMedGoogle Scholar
  • 70 Ashley D JB. Bony metaplasia in trachea and bronchi.  J Pathol . 1970;  102 186-188
    PubMedGoogle Scholar
  • 71 Muckleston H S. On so-called ``multiple osteomata'' of the tracheal mucous membrane.  Laryngoscope . 1909;  19 881-893
    PubMedGoogle Scholar
  • 72 Killian G. Ein unter Schwebelaryngoskopie entferter grosser subglottischer Tumor.  Laryngol Gesellsch Berlin . 1914;  17 7
    PubMedGoogle Scholar
  • 73 Akyol M, Martin A, Dhurandhar N, Miller R. Tracheobronchopathia osteochondroplastica: a case report and a review of the literature.  Ear Nose Throat J . 1993;  72 347-350
    PubMedGoogle Scholar
  • 74 Carr D, Olsen A. Tracheopathia osteoplastica.  JAMA . 1954;  155 1563-1565
    PubMedGoogle Scholar
  • 75 Gautam H P. Tracheopathia osteoplastica.  Postgrad Med J . 1968;  44 186-189
    PubMedGoogle Scholar
  • 76 Paaske P, Tang E. Tracheopathia osteoplastica in the larynx.  J Laryngol Otol . 1985;  99 305-310
    PubMedGoogle Scholar
  • 77 Hodges M, Isreal E. Tracheobronchopathia osteochondroplastica presenting as right middle lobe collapse.  Chest . 1988;  94 842-844
    PubMedGoogle Scholar
  • 78 Gleich L, Rebeiz E, Pankratov M, Shapshay S. The holmium:YAG laser-assisted otolaryngologic procedures.  Arch Otolaryngol . 1995;  121 1162-1166
    PubMedGoogle Scholar
  • 79 O'Reilly R, Marty A. Tracheopathia osteoplastica: case report.  Milit Med . 1978;  143 497-498
    PubMedGoogle Scholar
  • 80 Jackson C, Jackson C L. Benign tumors of the trachea and bronchi: with special reference to tumor-like formations of inflammatory origin.  JAMA . 1932;  99 1747-1753
    PubMedGoogle Scholar