PMC4501471_01
PMC4501471_02
PMC4501471_03
PMC4501471_04
Chest CT showing the tracheal morphology of the scabbard, irregular thickening and calcified nodules that protruding into the tracheobronchial lumen. Nodules arise from the anterior and lateral aspect of the inner tracheal wall. And the nodules arose from cartilage, posterior membranous wall of trachea is typically spared.
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Chest CT scanning showed scabbard tracheal with calcification, bronchial wall with calcification with irregularly cavity margin (Fig. 1).
Bronchoscopy showed widespread mucosal protuberances looking like pearl drops in the distal lateral and anterior walls of trachea. These nodules have "rock garden" or "cobblestone" appearance. Partly conglomerated and swollen mucosal lesions in the right main bronchus reaching to the upper lobe bronchus and similar lesions in the left main bronchus were detected. These nodules are hard on touch and gives gritty sensation while passing the scope through the lumen.
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Anterior walls of trachea were partly conglomerated and swollen mucosal lesions in the right main bronchus, reached to the upper lobe bronchus and similar lesions in the left main bronchus (Fig. 2).
Histopathological examination showed pseudostratified ciliated columnar epithelium mucosa of chronic inflammation with hemorrhage; epithelium was squamous metaplasia, hyperplasia and hyperkeratosis, submucosa cartilage osseous metaplasia, see lots of keratinized material with calcification.
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Histopathologic examination showed that the pseudostratified ciliated columnar epithelium mucosa of chronic inflammation with hemorrhage, that epithelium was squamous metaplasia, hyperplasia and hyperkeratosis, and lots of keratinized materials with calcification were found within submucosa cartilage osseous metaplasia (Fig. 3).