Introduction: A 57 yo female presenting with 4 weeks history of non-productive cough and hoarseness. There was note of fever, weight loss and anorexia. Physical examination, revealed stridor and ronchi. Bronchosocpy showed protruding cartilaginous structures covered with cottony exudates seen from the trachea to the right main bronchus. Histopathology showed numerous acid fast bacilli consistent with Mycobacterium Tuberculsis. Bronchial biopsy showed cartilage with areas of ossification supporting the diagnosis of Tracheobronchopathia Osteochondroplatica
Discussion: Tracheobronchopathia Osteochondroplatica is a rare disorder of the large airways with unknown etiology. It is characterized by multiple dense osseous and cartilaginous nodules at the submucosa of the tracheobronchial wall. True incidence and prevalence of this disease worldwide is unknown. Reported incidence at autopsy is 0.0003%. Bronchocsopic incidence was 0.02%-0.41%. Bronchoscopy is the best diagnostic procedure to directly visualize and biopsy the lesions.
Conclusion: There is no specific treatment for TO. Interventions aim to relieve airway obstruction. Our patient underwent both fiberoptic and rigid bronchocopy to remove the cartilaginous material. Treatment of Pulmonary Tuberculosis was done using INH/ RIF/PZA/EMB for 2months intensive phase followed by 4 months maintenance of INH/ RIF/EMB. Repeat AFB smears were negative.To the authors knowledge the coincidence of active M. Tuberculosis infection and Tracheobronchopathia Osteochondroplatica has never been described before.