Multi-Nodule of Large Airway: Tracheobronchopathia Osteochondroplastica, Two Cases Report and Literature Review

2021 ◽  
pp. 014556132110516
Author(s):  
He Jiang ◽  
Xiaoying Yang ◽  
Ying Guo
Keyword(s):  
Histological Analysis ◽  
Main Bronchus ◽  
Squamous Metaplasia ◽  
Clinical Manifestations ◽  
Benign Disease ◽  
The Other ◽  
Histological Findings ◽  
Patient Awareness ◽  
Large Airway ◽  
Tracheobronchopathia Osteochondroplastica

We report two subjects with tracheobronchopathia osteochondroplastica (TO), including the clinical manifestations, histological findings, and clinical treatments, which were analyzed retrospectively. One patient with TO was a 60-year-old woman, and the other was a 47-year-old man. The main clinical manifestations were cough, chest pain, and dyspnea. Computed tomography (CT) images showed that TO mainly occurred in the trachea and main bronchus. Histological analysis showed inflammatory exudation, squamous metaplasia, submucosal cartilaginous, and ossification. We present the two cases to increase physician and patient awareness of this benign disease and to improve their understanding of the disease manifestations and potential complications.

scholarly journals Tracheobronchopathia Osteochondroplastica: Two Different Facets of a Rare Entity

2020 ◽  
Author(s):  
Margarida Barata ◽  
Ricardo Gomes ◽  
Ana Catarina Moreira ◽  
Jorge Soares
Keyword(s):  
Histological Examination ◽  
Clinical Manifestation ◽  
Tracheobronchial Tree ◽  
Benign Disease ◽  
The Other ◽  
Productive Cough ◽  
Rare Entity ◽  
Severe Stenosis ◽  
Tracheobronchopathia Osteochondroplastica

Tracheobronchopathia osteochondroplastica (TBPO) is an uncommon benign disease, characterized by osseous or metaplastic cartilaginous nodules in the submucosa of the tracheobronchial tree. TBPO is easy to misdiagnose due to its non-specific clinical manifestation. We describe two cases of TBPO. The first patient was a 57-year-old woman with nocturnal dry cough and wheezing, in whom bronchoscopy revealed small diffuse mucosal irregularities involving the airway until the segmental bronchi. The other patient was a 69-year-old man with progressive worsening dyspnoea and productive cough presenting with severe stenosis of the trachea. Histological examination of both cases was consistent with TBPO. These cases highlight distinct forms of presentation of this rare entity.

scholarly journals Tracheobronchopathia Osteochondroplastica: A Case Report

2020 ◽  
Author(s):  
Salar Khazani Fard ◽  
Fathemeh Aghaeimeybodi
Keyword(s):  
Rheumatoid Arthritis ◽  
Case Report ◽  
Respiratory Infections ◽  
Main Bronchus ◽  
Chest Ct ◽  
Benign Disease ◽  
Productive Cough ◽  
Slow Progression ◽  
Chest Ct Scan ◽  
Tracheobronchopathia Osteochondroplastica

Introduction: Tracheobronchopathia Osteochondroplastica (TPO) is a rare disease that is characterized by bony canals located on the cartilage ring. We here report one case of tracheobronchopathia osteochondroplastica Case Report: A 64-year-old female patient was admitted to the hospital with a productive cough, sputum, and fever for ten days. Her chest CT scan showed mild thickening and irregularity associated with calcification in the trachea wall and main bronchus. The patient had rheumatoid arthritis, and after consultation with a rheumatologist, she received pneumonia treatment and then underwent bronchoscopy. Conclusion: TPO is a rare, benign disease with slow progression. Physicians should be aware of TPO and should consider it in patients with chronic cough and respiratory infections.

scholarly journals Clinical Case of Tracheobronchopathia Osteochondroplastica

2016 ◽  
Vol 23 (4) ◽  
pp. 201641
Author(s):  
Nataliia V. Chaplynska ◽  
Mykola M. Bagrii ◽  
Victoriia T. Rudnyk ◽  
Mariana Y. Koniuska ◽  
Svitlana L. Filipova ◽  
...  
Keyword(s):  
Bone Tissue ◽  
Histological Examination ◽  
Late Onset ◽  
Main Bronchus ◽  
Clinical Manifestations ◽  
Differential Diagnostics ◽  
Bronchial Obstruction ◽  
Virtual Bronchoscopy ◽  
Subepithelial Layer ◽  
Tracheobronchopathia Osteochondroplastica

Tracheobronchopathia osteochondroplastica (TO) is a rare chronic disease of the airways characterized by the growth of cartilage and/or bone tissue in the submucosal layer of the trachea and large bronchi with varying degrees of their lumen narrowing. In a significant percentage of cases diagnosis is made only posthumously due to the late onset of clinical manifestations and the considerable complexity of life-time diagnostics.The objective of the research was to conduct the clinical observation of OT.Materials and methods. A patient Sh., 49 years of age, was admitted to the department of differential diagnostics of regional clinical pulmonology center to determine the cause of prolonged cough and bronchial obstruction syndrome. Only fiber-optic bronchoscopy (FBS) was the only informative method of examination. On the mucous membrane of the trachea and right main bronchus the dense white protuberance was found. The biopsy material was taken. Histological examination revealed areas of calcified cartilage located in subepithelial layer. Results. Taking into account the reasearch data, the TO was suspected. The disease has a benign course for many years and is asymptomatic at initial stages. However, deformation and narrowing of the lumen of the trachea and the large bronchi with epithelial atrophy causes a disturbance of phlegm discharge. This promotes the development of infectious and inflammatory processes in the lung tissue. Patients complain of cough, hemoptysis, shortness of breath, chest pain. X-ray examination of the lungs may detect the infiltrative changes. The indicators of lung function are normal or correspond to the type of obstructive disorders. CT radiograph and virtual bronchoscopy determine the deformation and narrowing of the trachea and the large bronchi due to the elements of cartilage and bone tissue. Definitive diagnosis is possible only according to the results of FBS and histological examination.Conclusions. Awareness on such rare pathology as TO is essential, especially in patients with chronic cough. In case of absence of specific clinical and radiographic changes, the computed tomography of the chest and FBS with for histological examination sampling should be performed to confirm the diagnosis.

scholarly journals Clinical Characteristics of Six Cases of Tracheobronchopathia Osteochondroplastica

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Rong Guo ◽  
Mingming Zhou ◽  
Xiaohui Wei ◽  
Ling Niu
Keyword(s):  
Clinical Characteristics ◽  
Pulmonary Infection ◽  
Clinical Symptoms ◽  
Histopathological Examination ◽  
Main Bronchus ◽  
Clinical Manifestations ◽  
Symptomatic Treatment ◽  
Treatment Standard ◽  
The Right ◽  
Tracheobronchopathia Osteochondroplastica

Objective. To investigate the clinical characteristics of tracheobronchopathia osteochondroplastica (TO). Methods. The clinical data of six patients with TO from November 2016 to November 2018 were retrospectively analyzed. The etiology, clinical manifestations, diagnosis, and treatment of TO were summarized. Result. All six patients with TO were middle-aged males, confirmed by histopathological examination. The main clinical symptoms were cough, sputum, hemoptysis, chest pain, and repeated pulmonary infection. Some patients could make a preliminary diagnosis by chest CT, and bronchoscopy showed that TO mainly occurred in the trachea and the main bronchus and was more likely to invade the right bronchus. The treatment mainly includes anti-infection, phlegm-resolving, and other symptomatic treatment. Conclusion. TO is a benign disease predisposing to adults, and males are more likely to be affected. Its clinical manifestations are lack of specificity, and the cause may be related to chronic infection. Bronchoscopy combined with histopathological examination is the primary approach for the diagnosis of TO. There is no well-recognized treatment standard for TO, and the judgment of therapeutic effect is inconsistent. It is necessary to improve the understanding of this disease from a clinical perspective.

scholarly journals Gasperini Syndrome: A Case Report and Systematic Review and Proposing a New Definition

2020 ◽  
Vol 12 (3) ◽  
pp. 433-439
Author(s):  
Riwaj Bhagat ◽  
Siddharth Narayanan ◽  
Marwa Elnazeir ◽  
Thong Diep Pham ◽  
Robert Paul Friedland ◽  
...  
Keyword(s):  
Systematic Review ◽  
Brain Mri ◽  
Cranial Nerves ◽  
Clinical Manifestations ◽  
The Other ◽  
Neurological Deficits ◽  
Brainstem Stroke ◽  
Neurological Features ◽  
The Right ◽  
Core Features

Gasperini syndrome (GS), a rare brainstem syndrome, is featured by ipsilateral cranial nerves (CN) V–VIII dysfunction with contralateral hemibody hypoesthesia. While there have been 18 reported cases, the GS definition remains ambiguous. We report a new case and reviewed the clinical features of this syndrome from all published reports to propose a new definition. A 57-year-old man with acute brainstem stroke had right CN V–VIII and XII palsies, left body hypoesthesia and ataxia. Brain MRI showed an acute stroke in the right caudal pons and bilateral cerebellum. After a systematic review, we classified the clinical manifestations into core and associate features based on the frequencies of occurring neurological deficits. We propose that a definitive GS requires the presence of ipsilateral CN VI and VII palsies, plus one or more of the other three core features (ipsilateral CN V, VIII palsies and contralateral hemibody hemihypalgesia). Additionally, GS, similar to Wallenberg’s syndrome, represents a spectrum that can have other associated neurological features. The revised definition presented in this study may enlighten physicians with the immediate recognition of the syndrome and help improve clinical localization of the lesions and its management.

scholarly journals Inflammatory Skin Lesions in Three SARS-CoV-2 Swab-Negative Adolescents: A Possible COVID-19 Sneaky Manifestation?

2021 ◽  
Vol 13 (2) ◽  
pp. 181-188
Author(s):  
Giuseppe Ingravallo ◽  
Francesco Mazzotta ◽  
Leonardo Resta ◽  
Sara Sablone ◽  
Gerardo Cazzato ◽  
...  
Keyword(s):  
Electron Microscopy ◽  
Respiratory Symptoms ◽  
Clinical Manifestations ◽  
Skin Lesions ◽  
Sweat Glands ◽  
Histological Findings ◽  
Immune Mediated ◽  
Nodular Lesions ◽  
Immunohistochemical Evidence ◽  
Eccrine Sweat Glands

Coronavirus disease 19 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is associated with various clinical manifestations, including skin lesions. In particular, during the COVID-19 pandemic lock-down period numerous chilblain-like lesions, mainly located on the feet, were observed in adolescents. The latter were often asymptomatic or associated with very mild respiratory symptoms. Here, we report three cases of acral nodular lesions in SARS-CoV-2 swab-negative adolescents with histological findings of chronic immune-mediated inflammation and immunohistochemical evidence of SARS-CoV-2 spike glycoproteins in endothelial cells and eccrine sweat glands. In one of these cases, the virus presence was confirmed by electron microscopy.

scholarly journals Mucosal Changes in the Trachea and Main Bronchi of Newborn Infants after Nasotracheal Intubation

1975 ◽  
Vol 3 (3) ◽  
pp. 209-217 ◽  
Author(s):  
G. C. Fisk ◽  
W. de C. Baker
Keyword(s):  
Endotracheal Tube ◽  
Main Bronchus ◽  
Squamous Metaplasia ◽  
Nasotracheal Intubation ◽  
Newborn Infants ◽  
Respiratory Epithelium ◽  
Lower Trachea ◽  
Nasotracheal Tube ◽  
Mucosal Changes ◽  
The Right

Permanent sequelae of nasotracheal intubation are uncommon, but acute ulceration and squamous metaplasia occur. Histological sections from the trachea and main bronchi were examined in 12 infants. A nasotracheal tube had been inserted during the first two weeks of life of these infants and had been in place for more than one week. In four cases the patient died some time (7 to 108 days) after extubation. Similar sections from patients who were not intubated, intubated only for attempted resuscitation, or intubated for several hours were studied for comparison. The sections were classified according to the degree of mucosal loss and metaplasia, and the extent of the lesions was estimated. Squamous change was seen in most sections from all 12 patients with the exception of one who died 57 days after extubation. Some respiratory epithelium was seen in all patients. In the eight patients who died while intubated, the changes were more marked in the right main bronchus than the left in seven, and more marked in the lower trachea than the upper in five. In the two patients intubated for several hours, in addition to mucosal loss, early metaplasia was seen. It is suggested that mucosal loss is replaced by the squamous metaplasia, and that trauma caused by suction catheters in the lower trachea and right main bronchus is more extensive than that due to the endotracheal tube itself.

scholarly journals Rolling technique for treatment of left displacement of the large colon in horses: 11 cases (2004-2009)

2013 ◽  
Vol 65 (2) ◽  
pp. 329-334 ◽  
Author(s):  
P.A. Canola ◽  
J.C. Lacerda Neto ◽  
J.C. Canola
Keyword(s):  
General Anesthesia ◽  
Clinical Case ◽  
Clinical Manifestations ◽  
The Other ◽  
Safe Procedure ◽  
Emergency Procedures ◽  
Case Selection ◽  
Percutaneous Ultrasonography ◽  
Rectal Palpation

The left displacement of the large colon, a condition that commonly occurs in horses, has two clinical manifestations. Different treatments including medical treatment, rolling the horse under general anesthesia or surgical correction have been recommended. The diagnosis can often be made by rectal examination and confirmed by percutaneous ultrasonography. During the period between 2004 and 2009, 11 horses were treated for left displacement of the large colon by rolling the horses under general anesthesia, using a slightly different technique than the ones previously described. The clinical case selection was based on rectal palpation confirmed with ultrasonogram. Nine animals were successfully treated and two had to be submitted to surgery after three attempts of rolling. No short or long term complications were observed after the procedure. Only one animal had a recurrence of the clinical manifestation 10 months after the first treatment and was successfully rolled once again. Despite a bit different from the other rolling procedures, this also proved to be an effective procedure. Rolling a horse even when attempted more than once showed to be a safe procedure, however, we reinforce the need for special attention following the procedure in order to establish proper emergency procedures in case complications occur.

scholarly journals Emergence of a Novel Reassortant Strain of Bluetongue Serotype 6 in Israel, 2017: Clinical Manifestations of the Disease and Molecular Characterization

Viruses ◽  
2019 ◽  
Vol 11 (7) ◽  
pp. 633 ◽  
Author(s):  
Natalia Golender ◽  
Avi Eldar ◽  
Marcelo Ehrlich ◽  
Yevgeny Khinich ◽  
Gabriel Kenigswald ◽  
...  
Keyword(s):  
South African ◽  
Bluetongue Virus ◽  
Mediterranean Basin ◽  
Rna Viruses ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
The Other ◽  
Reassortant Strain ◽  
Cattle Farms ◽  
The Mediterranean Basin

Reassortment contributes to the evolution of RNA viruses with segmented genomes, including Bluetongue virus (BTV). Recently, co-circulation of natural and vaccine BTV variants in Europe, and their ensuing reassortment, were proposed to promote appearance of novel European BTV strains, with potential implications for pathogenicity, spread and vaccination policies. Similarly, the geographical features of the Mediterranean basin, which spans over portions of three continents, may facilitate the appearance of clinically relevant reassortants via co-circulation of BTV strains of African, Asian and European origins. In August–October 2017, BTV serotype 6 (BTV-6) was identified in young animals exhibiting classical clinical signs of Bluetongue (BT) at Israeli sheep and cattle farms. Sequencing and pairwise analysis of this Israeli BTV-6 isolate revealed the closest sequence homology of its serotype-defining Segment 2 was with that of South African reference BTV-6 strain 5011 (93.88% identity). In contrast, the other viral segments showed highest homology (97.0%–99.47% identity) with BTV-3, -4 and -9 of Mediterranean and African origins. Specifically, four viral segments were nearly identical (99.13%–99.47%), with Tunisian and Italian BTV-3 strains (TUN2016 and SAD2018, correspondingly). Together, our data suggest that Mediterranean co-circulation and reassortment of BTV-3 and BTV-6 drove the emergence of a novel and virulent BTV-6 strain

scholarly journals Acute Megakaryocytic Leukemia with or Without Acquired Trisomy 21 in 15 Pediatric Patients

2020 ◽  
Author(s):  
Wenzhi ZHANG ◽  
Hui LI ◽  
Jingzhen LIU ◽  
Jiawei XU ◽  
Jinjin HAO ◽  
...  
Keyword(s):  
Trisomy 21 ◽  
Poor Prognosis ◽  
Clinical Characteristics ◽  
Pediatric Patients ◽  
Laboratory Data ◽  
Clinical Manifestations ◽  
The Other ◽  
Hematopoietic Stem ◽  
Acute Megakaryocytic Leukemia

Abstract The knowledge of clinical characteristics and prognosis of pediatric acute megakaryocytic leukemia (AMKL) with or without acquired +21 was limited. We reported 15 AMKL pediatric patients without Down Syndrome (four cases with acquired +21 and 11 cases without acquired +21) with the clinical manifestations, laboratory data, and prognosis. The clinical features and laboratory data between patients with acquired +21 and patients without acquired +21 are similar. As for prognosis, three of the 11 cases without acquired +21 obtained complete remission (CR) after 1st induction. The median follow-up time of the 11 cases was 9 months. Among four cases with acquired +21, one case gave up treatment during 1st induction, one obtained CR after 1st induction and was still alive after 49 months of follow-up. One case obtained CR after 2nd induction and was still alive for 15 months of follow-up after bone marrow transplantation, the other patient was planning for allogeneic hematopoietic stem cell transplantation (HSCT) without CR. The median follow-up time of the four cases was 12 months. None relapsed in our study. In conclusion, acquired trisomy 21 may not be an indicator for poor prognosis. Cytogenetics analysis can help us for diagnosis stratification, prognostic judgment and individualized treatment of AMKL.

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