Case Report: Tracheobronchopathia osteochondroplastica with Pseudomonas aeruginosa recovered from bronchoalveolar lavage fluid
- 1Department of Respiratory Medicine, Suizhou Hospital, Hubei University of Medicine, Suizhou, China
- 2Department of Pathology, Suizhou Hospital, Hubei University of Medicine, Suizhou, China
- 3Department of Medical Imaging, Suizhou Hospital, Hubei University of Medicine, Suizhou, China
Abstract
Background: Tracheobronchopathia osteochondroplastica (TO) is an uncommon benign disorder characterized by osseous and/or cartilaginous submucosal nodules involving predominantly the anterolateral tracheobronchial walls. This case illustrates multimodal diagnosis and cautious interpretation of concomitant lower-airway bacterial recovery.
Case presentation: A 63-year-old man presented with a 3-month history of cough and scant whitish mucoid sputum. Computed tomography (CT) demonstrated partially calcified anterolateral tracheobronchial nodules with relative posterior-wall sparing, a right-sided patchy pulmonary opacity, and multiple pulmonary nodules. Retrospective airway measurements showed a minimum tracheal luminal area of 179.4 mm2 and a minimum diameter of 10.0 mm at the same level. Bronchoscopy revealed hard yellow-white nodules involving the trachea and proximal bronchi; biopsy showed mature lamellar bone, supporting TO. A pooled bilateral bronchoalveolar lavage specimen obtained after empirical piperacillin/tazobactam had been started yielded Pseudomonas aeruginosa at >10⁴ CFU/mL, susceptible to piperacillin/tazobactam and levofloxacin. The patient received 5 days of intravenous piperacillin/tazobactam followed by 9 days of oral levofloxacin and airway-clearance treatment, with symptomatic improvement. He completed the oral course without reported adverse effects. At an outpatient visit approximately 3 months after discharge, he was asymptomatic. The treating clinician's comparison of follow-up CT with baseline images showed resolution of the pulmonary opacity, unchanged airway nodules, and stable pulmonary nodules. Repeat cultures were not obtained.
Conclusion: Concordant CT, bronchoscopic, and supportive histopathologic findings establish the diagnostic pattern of TO. Clinical and radiologic improvement supported a concomitant respiratory infection, but the organism's causal role and any causal contribution of TO remained unproven. This distinction supports conservative airway management and continued surveillance without attributing every pulmonary abnormality to TO.
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BibTeX
@article{li2026case,
title = {{Case Report: Tracheobronchopathia osteochondroplastica with Pseudomonas aeruginosa recovered from bronchoalveolar lavage fluid}},
author = {Jinlin Li and Dongmei Kuang and Daihua Hu and Canguo Xie and Ling Liao and Xin Dong},
journal = {Frontiers in Medicine},
year = {2026},
month = oct,
doi = {10.3389/fmed.2026.1972198},
url = {https://doi.org/10.3389/fmed.2026.1972198},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Case Report: Tracheobronchopathia osteochondroplastica with Pseudomonas aeruginosa recovered from bronchoalveolar lavage fluid
AU - Jinlin Li
AU - Dongmei Kuang
AU - Daihua Hu
AU - Canguo Xie
AU - Ling Liao
AU - Xin Dong
PY - 2026
DA - 2026/10/21
JO - Frontiers in Medicine
DO - 10.3389/fmed.2026.1972198
UR - https://doi.org/10.3389/fmed.2026.1972198
AB - Background: Tracheobronchopathia osteochondroplastica (TO) is an uncommon benign disorder characterized by osseous and/or cartilaginous submucosal nodules involving predominantly the anterolateral tracheobronchial walls. This case illustrates multimodal diagnosis and cautious interpretation of concomitant lower-airway bacterial recovery. Case presentation: A 63-year-old man presented with a 3-month history of cough and scant whitish mucoid sputum. Computed tomography (CT) demonstrated partially calcified anterolateral tracheobronchial nodules with relative posterior-wall sparing, a right-sided patchy pulmonary opacity, and multiple pulmonary nodules. Retrospective airway measurements showed a minimum tracheal luminal area of 179.4 mm2 and a minimum diameter of 10.0 mm at the same level. Bronchoscopy revealed hard yellow-white nodules involving the trachea and proximal bronchi; biopsy showed mature lamellar bone, supporting TO. A pooled bilateral bronchoalveolar lavage specimen obtained after empirical piperacillin/tazobactam had been started yielded Pseudomonas aeruginosa at >10⁴ CFU/mL, susceptible to piperacillin/tazobactam and levofloxacin. The patient received 5 days of intravenous piperacillin/tazobactam followed by 9 days of oral levofloxacin and airway-clearance treatment, with symptomatic improvement. He completed the oral course without reported adverse effects. At an outpatient visit approximately 3 months after discharge, he was asymptomatic. The treating clinician's comparison of follow-up CT with baseline images showed resolution of the pulmonary opacity, unchanged airway nodules, and stable pulmonary nodules. Repeat cultures were not obtained. Conclusion: Concordant CT, bronchoscopic, and supportive histopathologic findings establish the diagnostic pattern of TO. Clinical and radiologic improvement supported a concomitant respiratory infection, but the organism's causal role and any causal contribution of TO remained unproven. This distinction supports conservative airway management and continued surveillance without attributing every pulmonary abnormality to TO.
SN - 2296-858X
ER -