PMC7502850_01
Radiology. (A) Chest radiograph and (B, C, D) computed tomography (CT) scan showed (B) no parenchymal lesion but airway calcifications. Irregular narrowing and thickening with calcification were found on (C) the upper trachea and (D) the right main bronchus.
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A chest radiograph and a chest computed tomography (CT) scan revealed neither focal haziness in the lungs nor obstruction of the airways (Fig. 1A-B). The CT scan showed tracheobronchial wall calcification from the trachea to the main bronchi and segmental bronchi (Fig. 1C-D).
Bronchoscopy. Irregular submucosal nodules were found on (A) the whole trachea, (B) the right lower lobar bronchi, and (C) the left lingular and lower lobar bronchi. (D) The pin-point narrowing of the left lingular bronchus was relieved by tissue resection using a Diode Laser.
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Under bronchoscopy, the whole trachea, the right middle and lower, and the left main and lingular bronchi were covered by submucosal whitish nodules with capillary dilatation (Fig. 2).
Pathology. (A) Hematoxylin and Eosin staining showed osteochondroid metaplasia (open arrow) and pink amorphous material (closed arrow). (B) Polarized microscopy revealed apple-green birefringence. (For interpretation of the references to colour in this figure legend, the reader is referred to the Web version of this article.)
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The pathology showed pinkish amorphous deposition in the bronchial wall with multifocal osteochondroid metaplasia (Fig. 3A). Using Congo-red staining, apple-green birefringence was observed under the polarized microscope (Fig. 3B).