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J Thorac Cardiovasc Surg 2006;132:714-716
© 2006 The American Association for Thoracic Surgery

Brief Communication

Tracheobronchopathia osteochondroplastica: A rare cause of tracheal stenosis—"TPO stenosis"

Amir M. Khan, MD, FRCS, MSca,*, Chang Shim, MDa, Nichelle Simmons, MDb, Virginia Chung, MDa, Daniel D. Altermanc, Linda B. Haramatic, Andrew R. Bermana

a Department of Pulmonary, and Albert Einstein College of Medicine, Montefiore & Jacobi Medical Center, Bronx, NY
b Department of Pathology, and Albert Einstein College of Medicine, Montefiore & Jacobi Medical Center, Bronx, NY
c Department of Radiology, and Albert Einstein College of Medicine, Montefiore & Jacobi Medical Center, Bronx, NY

Received for publication March 29, 2006; revisions received April 27, 2006; accepted for publication May 19, 2006.

* Address for reprints: A. M. Khan, MBBS, FRCS, MSc, 3600 Fieldston Rd 7C, Bronx, New York 10463 (Email: dramirkhan@hotmail.com).

The first 20% of the full text of this article appears below.


Figure 1
Dr Khan


Tracheobronchopathia osteochondroplastica, or tracheopathia osteoplastica (TPO), is characterized by multiple cartilaginous or bony submucosal nodules that project into the tracheal and bronchial lumina and may or may not cause respiratory symptoms. The nodules always originate in airway cartilages and typically spare the posterior membranous wall.1Go

TPO was described by Wilks in the mid-1800s; by the 1970s more than 245 cases of TPO had been reported. TPO does not produce any characteristic symptoms or signs to indicate the diagnosis. The disease frequently manifests as chronic cough and wheezing, which frequently leads to the mistaken diagnosis of asthma or chronic bronchitis. Many patients remain free of symptoms. Larger nodules project into the airway lumen causing the commonly reported symptoms of chronic cough, hoarseness, dyspnea, hemoptysis, and recurrent respiratory infections. In rare instances, TPO may progress to tracheal stenosis with critical airway obstruction.

We herein describe a case of TPO complicated by tracheal stenosis, "TPO stenosis," necessitating surgical resection. To date only a handful of cases in which surgical intervention was required have been described in the literature.2-5Go

Clinical Summary

A 47-year-old woman with a medical history of asthma (mild, intermittent, occasional use of albuterol, one prior intubation) and alcoholic liver disease presented with progressive stridor of 3 months' duration. The patient's . . . [Full Text of this Article]






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