Question:

Regarding differential diagnosis and management of Tracheobronchopathia Osteochondroplastica, mark true?
1. Unlike amyloidosis, in Tracheobronchopathia Osteochondroplastica the posterior membrane is typically spared.
2. Relapsing polychondritis and Tracheobronchopathia Osteochondroplastica both cause nodular appearance of inner tracheal lining.
3. Interferon therapy offers a definitive treatment for this condition.
4. Focal stenosis may be treated with nodule removal by forceps, laser, cryotherpay and external beam irradiation.
5. The prognosis is always bad.





Answer:

The correct answers for the question "Regarding differential diagnosis and management of Tracheobronchopathia Osteochondroplastica, mark true?" are:

1. Unlike amyloidosis, in Tracheobronchopathia Osteochondroplastica the posterior membrane is typically spared.

4. Focal stenosis may be treated with nodule removal by forceps, laser, cryotherpay and external beam irradiation.



Explanation
1. In Tracheobronchopathia Osteochondroplastica the nodules are seen over the cartilaginous portion only hence, the posterior membranous portion remains spared. [But unlike TPO, the amyloidosis does not spare the posterior wall of the trachea]

2. Relapsing polychondritis involves the cartilage layer only without affecting submucosa and mucosa. [Although relapsing polychondritis may have a similar distribution as TPO, it characteristically presents with thickened and deformed cartilage with or without calcification, and the inner wall is smooth without discrete intraluminal nodules formation].

3. Till date no definitive treatment is available. [There is no definitive treatment available for TPO, hence treatment is only offered to symptomatic cases]

4. Although it is not possible to remove all the nodules, some of the nodules can be removed to relieve obstruction. [In severe cases like airway stenosis, various bronchoscopic interventions have been tried like removal of nodules by forceps, laser ablation, cryotherapy and external beam irradiation].

5. The prognosis is not bad in all cases. [Prognosis is generally good but it is related with degree of airway involvement and luminal narrowing].



From the manuscript:
Tracheobronchopathia Osteochondroplastica - A rare or an overlooked entity?
Radiology Case. 2013 Mar; 7(3):16-25


This article belongs to the Chest section.




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From the manuscript

Tracheobronchopathia Osteochondroplastica - A rare or an overlooked entity?

Free full text article: Tracheobronchopathia Osteochondroplastica - A rare or an overlooked entity?

Abstract
Tracheobronchopathia osteochondroplastica is an idiopathic non-malignant disease of large airways featured by submucosal cartilaginous to osseous nodules overlying the cartilaginous rings, which may be focal or diffuse. Clinical presentation varies from asymptomatic to symptoms like breathlessness, recurrent chest infections, cough and hemoptysis. Due to the lack of awareness of this disease, it remains an under recognized entity. We are describing the computed tomography and bronchoscopic findings of two recently diagnosed cases at our institute. The purpose of this report is to familiarize radiologists with imaging appearance of this condition, with the goal of increasing clinical suspicion of this uncommon condition.






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