Tracheopathia osteochondroplastica.

The case of a male, 61 years of age, presenting with occasional hemoptysis and shortness of breath (duration of 1 year) is reported. Congestive heart failure was presumed and supported by chest x-ray and echocardiography. The patient improved with diuretic and angiotensin converting enzyme (ACE) inhibitor therapy, but continued to experience cough and occasional hemoptysis. Bronchoscopy revealed numerous firm nodular projections within the trachea with distribution along the cartilaginous rings. Tracheopathia osteochondroplastica (TPO) was diagnosed. TPO is an uncommon, benign, but slowly progressive disease of unknown etiology. It is characterized by endoluminal projection of cartilaginous and bony nodules arising in the submucosa of the trachea. Involvement may extend to lobar or segmental bronchi. TPO should be considered in cases where cough, dyspnea, persistent pulmonary infection, hoarseness, or recurrent hemoptysis remain after appropriate treatment of other presumptive underlying causes.