Dyspnea & cough.
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The trachea and main bronchi show thickened irregular tracheal cartilage with sparing of posterior membranous portions. There are small irregular calcific nodules along its inner tracheal aspect, protruding into the tracheal lumen associated with accumulation of the mucus . The trachea shows reduced transverse diameter yet with no focal significant luminal compromise.
Azygous lobe (incidental finding).
Diagnosis confirmed by fiberoptic bronchoscopy.
Tracheobronchopathia osteochondroplastica (TO) is a very rare idiopathic non neoplastic tracheo-bronchial abnormality.
It's characterized by development of osseous or cartilaginous 1-8mm nodules or both in the submucosa of the trachea and bronchial walls. They may be either focal or diffuse.
These nodules arise from cartilage, therefore posterior membranous wall of trachea is typically spared; which differentiates it from many other airway diseases such as tracheobronchial amyloidosis and Wegener granulomatosis.
The appearance is much more irregular than that seen with senile cartilage calcification (DDx Case).