Tracheobronchial involvement in relapsing polychondritis diagnosed on endobronchial ultrasound. 2013

Dararat Eksombatchai, and Viboon Boonsarngsuk, and Naparat Amornputtisathaporn, and Thitiporn Suwatanapongched, and Noriaki Kurimoto
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Thailand.

Respiratory tract chondritis is not uncommon in patients with relapsing polychondritis (RP); however, diagnosing this condition remains problematic, especially in patients whose extrapulmonary manifestations do not predominate, as there are broad differential diagnoses of airway obstruction. We herein report the case of a 56-year-old man who presented with cough and dyspnea. Computed tomography of the chest demonstrated diffuse smooth thickening of the visualized tracheobronchial wall with a moderately narrowed lumen. Airway chondritis was diagnosed on endobronchial ultrasound following demonstration of thickening of the submucosal and cartilaginous layers in the anterior and lateral aspects of the bronchial wall, while the posterior region expressed less involvement. In conjunction with nasal and auricular chondritis, which were previously overlooked, RP was finally diagnosed.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011081 Polychondritis, Relapsing An acquired disease of unknown etiology, chronic course, and tendency to recur. It is characterized by inflammation and degeneration of cartilage and can result in deformities such as floppy ear and saddle nose. Loss of cartilage in the respiratory tract can lead to respiratory obstruction. Polychondritis, Chronic Atrophic,Atrophic Polychondritides, Chronic,Atrophic Polychondritis, Chronic,Chronic Atrophic Polychondritides,Chronic Atrophic Polychondritis,Polychondritides, Chronic Atrophic,Polychondritides, Relapsing,Relapsing Polychondritides,Relapsing Polychondritis
D001980 Bronchi The larger air passages of the lungs arising from the terminal bifurcation of the TRACHEA. They include the largest two primary bronchi which branch out into secondary bronchi, and tertiary bronchi which extend into BRONCHIOLES and PULMONARY ALVEOLI. Primary Bronchi,Primary Bronchus,Secondary Bronchi,Secondary Bronchus,Tertiary Bronchi,Tertiary Bronchus,Bronchi, Primary,Bronchi, Secondary,Bronchi, Tertiary,Bronchus,Bronchus, Primary,Bronchus, Secondary,Bronchus, Tertiary
D001999 Bronchoscopy Endoscopic examination, therapy or surgery of the bronchi. Bronchoscopic Surgical Procedures,Surgical Procedures, Bronchoscopic,Bronchoscopic Surgery,Surgery, Bronchoscopic,Bronchoscopic Surgeries,Bronchoscopic Surgical Procedure,Bronchoscopies,Surgeries, Bronchoscopic,Surgical Procedure, Bronchoscopic
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D014132 Trachea The cartilaginous and membranous tube descending from the larynx and branching into the right and left main bronchi. Tracheas
D019160 Endosonography Ultrasonography of internal organs using an ultrasound transducer sometimes mounted on a fiberoptic endoscope. In endosonography the transducer converts electronic signals into acoustic pulses or continuous waves and acts also as a receiver to detect reflected pulses from within the organ. An audiovisual-electronic interface converts the detected or processed echo signals, which pass through the electronics of the instrument, into a form that the technologist can evaluate. The procedure should not be confused with ENDOSCOPY which employs a special instrument called an endoscope. The "endo-" of endosonography refers to the examination of tissue within hollow organs, with reference to the usual ultrasonography procedure which is performed externally or transcutaneously. Echo-Endoscopy,Endoscopic Ultrasonography,Endoscopy, Echo,Endoscopy, Ultrasonic,Ultrasonic Endoscopy,Ultrasonography, Endoscopic,Echo Endoscopies,Echo Endoscopy,Echo-Endoscopies,Endoscopic Ultrasonographies,Endoscopies, Echo,Endoscopies, Ultrasonic,Endosonographies,Ultrasonic Endoscopies,Ultrasonographies, Endoscopic

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