PMC3616182_01
Chest computed tomography. Arrows indicate the abnormal prominence of the tracheal wall into the intratracheal space. Theses changes are associated with the bronchoscopic abnormalities of the tracheal cartilage of Figure 2.
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Her chest X-ray was normal, while her chest CT showed some protuberances in the trachea (Figure 1).
Bronchoscopic view of the trachea before (A, B) and after (C, D) systemic corticosteroid treatment. Characteristic deformities of tracheal cartilage are observed (A, B). These deformities disappear (A   C) (B   D) after systemic corticosteroid therapy, and diffuse mucosal edema develops.
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In accordance with the CT findings, bronchoscopy revealed that both ends of the bronchial cartilage crescent protruded into the bronchial lumen from the trachea to both main bronchi (Figure 2A,B). With therapy, the bronchial cartilage deformity disappeared, while diffuse edema of the bronchial mucosa and dynamic collapse of the major airway, typical features of respiratory RP, occurred (Figure 2C,D).
Pathological examination of the deformed part of the tracheal cartilage (hematoxylin-eosin stain; magnification x100). Deformity (A) and necrosis (B) of cartilaginous tissue show chondritis. Arrows in the figures show typical changes.
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On pathology, degeneration and necrosis of bronchial cartilage (Figure 3) suggesting the diagnosis of RP were seen.