PMC8627817_01
Computed tomography (CT) shows multifocal irregular thickening and nodularity with calcified changes in the tracheobronchial tree, sparing the posterior tracheal wall.
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Chest computed tomography (CT) showed nodularity, irregularity, and stenotic changes in the mucosa with areas of ossification throughout the tracheal lumen as well as in both main bronchi (Fig. 1).
At the time of the diagnosis, CT showed mild subpleural reticulation, ground-glass opacity and bronchiectasis in the left lower lobe medial basal segment (A). Two years later, follow-up CT showed an interval increased extent of subpleural fine reticulations, honeycomb and bronchiectasis in both lower lobe basal segments, suggesting the progression of underlying idiopathic pulmonary fibrosis (B).
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Faint ground-glass opacity (GGO), mild reticulation, and honeycombing cystic changes were observed in the subpleural area of both lower lobes (Fig. 2A). Two years later, follow-up CT showed interval increased extent of honeycombs, subpleural reticulation, and GGO in both lower lobes, indicating progression of ILD (Fig. 2B).
An endoscopic view showing the involvement of the anterior and lateral aspects of the trachea (A) and the increased extent of calcified nodules (B).
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The biopsy findings for the trachea showed calcification in the mucosa and ossification in the submucosa (Fig. 3A). Compared with the previous findings, the lesions of TPO throughout the tracheal lumen had also progressed (Fig. 3B).
PMC8627817_02
(A, B) CT with coronal images shows diffuse small tracheobronchial nodules with/without calcification that produce luminal irregular narrowing of the tracheobronchial tree, sparing the posterior tracheal wall. (C) CT shows mild pure reticulation and faint ground-glass opacity in the left lower lobe medial basal segment, suggesting a possible interstitial lung abnormality.
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On chest CT, very mild fine reticulations and coarse GGO in the left lower lobe were observed (Fig. 4C). There was also severe irregular nodular and calcified thickening of the mucosa throughout the entire trachea and in both main bronchi (Fig. 4A, B).
Endoscopic view showing severe irregular nodules and calcification of the tracheobronchial tree, sparing the posterior tracheal wall.
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The nodules of the trachea were very hard, and tissue was difficult to obtain (Fig. 5).