Tracheal wall thickening may have several causes. For diagnostic purposes, tracheal thickening may be categorised by length of airway involvement in order to narrow the differential diagnoses. Note that some aetiologies may be associated with either focal or diffuse pattern of involvement.
Differential diagnosis
Focal tracheal wall thickening
- iatrogenic - resulting from prior intubation/tracheostomy
- inhalational injury
- tumour
- primary - squamous cell carcinoma, adenoid cystic carcinoma, mucoepidermoid, neuroendocrine/carcinoid
- secondary - metastasis
- tracheobronchial papillomatosis
- granulomatous processes
Diffuse tracheal wall thickening
- post-intubation stenosis
- amyloidosis
- inflammatory bowel disease
- tracheobronchial papillomatosis
- relapsing polychondritis: characteristic sparing of posterior tracheal membrane
- granulomatous processes
- granulomatosis with polyangiitis
- sarcoidosis
- infection (e.g. rhinoscleroma, tuberculosis)
- tracheobronchopathia osteochondroplastica: also spares the posterior trachea but also has nodular calcifications
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