Pulmonary spread of tracheobronchial papillomatosis
Long history of voice changes, cough and dyspnea. Recent exacerbation with asphyxia requiring tracheostomy.
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Multiple cavitating nodules and masses bilaterally with posterior and basal predilection. Numerous endoluminal tracheal soft-tissue lesions obstructing upper airways. Tracheostomy tube in place.
Findings are suggestive of pulmonary spread of tracheobronchial papillomatosis.
Tracheobronchial papillomatosis is caused by human papilloma virus types 6 and 11. Less than 1% of patients with tracheobronchial papillomatosis have parenchymal extension. Juvenile onset type usually have a worse prognosis with higher incidence of pulmonary spread. Proposed mechanism of spread is associated with aerial dissemination of papilloma fragments facilitated by laryngeal and tracheal interventions.