Year: 2025
Type: article
Study design: Case Report
Abstract: His general physical and systemic examination at presentation were unremarkable.His sputum examination was negative for acid-fast bacilli.His routine blood investigations were within normal limits.His chest radiograph was normal.Spirometry did not reveal any abnormality and showed no significant bronchodilator reversibility.Electrocardiogram and stress cardiac testing were normal, with no inducible ischemic changes.Highresolution computed tomography (HRCT) of thorax was done, which showed numerous calcified nodular opacities protruding from the anterior and lateral wall of the trachea with sparing of posterior membranous wall (Figs 1A to C).A flexible bronchoscopy done revealed diffuse mucosal nodularity of tracheobronchial wall up to the segmental level, with sparing of posterior membrane (Fig. 1D).Endobronchial biopsy was attempted, but could not be obtained due to gritty consistency of the nodular mucosa.A clinical diagnosis of TBO was made.He was counseled regarding the nature of his disease and treatment options in IntroductIon "Chronic cough" in adults is defined as one that lasts longer than 8 weeks.It affects 5-10% of the adult population and has an impact on their quality of life. 1 The common causes are asthma, chronic obstructive airway disease, nonasthmatic eosinophilic bronchitis (NAEB), gastroesophageal reflux disease (GERD), and upper airway cough syndrome (UACS).The initial evaluation is to identify any danger signs that warrant urgent attention.Herein, we present a case of chronic cough in a 39-year-old gentleman, attributed to tracheobronchopathia osteochondroplastica (TBO).TBO is a benign disease affecting the larger airways, characterized by the presence of multiple, sessile cartilaginous and osseous submucosal nodules leading to narrowing of airway lumen.It usually spares posterior membrane of the tracheal wall, with intact overlying mucosa comprised of either normal or metaplastic epithelium. 2 The classic radiologic and bronchoscopic findings clinch the diagnosis of TBO.Awareness among physicians and bronchoscopists is essential for making the diagnosis. case descrIptIonA 39-year-old gentleman presented with a 2-year history of cough with occasional mucoid expectoration, accompanied by retrosternal chest pain.The cough has no diurnal or seasonal variation, was not aggravated by food intake, or had no allergic triggers.The chest pain was dull aching type in the retrosternal region, without any radiation or aggravation with exertion or food intake.He denied history of breathlessness, wheeze, hemoptysis, anorexia, or weight loss.He was a never-smoker and had no medical comorbidities.He received multiple courses of glucocorticoids and inhaled bronchodilators/glucocorticoids (GC) without any clinical benefit.He also denied relief with proton pump inhibitors and prokinetics.
Institutions: Nizam's Institute of Medical Sciences, Medicover Hospitals
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4416124758