Diagnosis of tracheopathia osteoplastica by computed tomography

Tracheopathia osteoplastica is a relatively rare benign disease of the trachea and major bronchi, characterized by cartilaginous and bony submucosal nodules covered by intact mucosa, which may cause narrowing and rigidity of the upper airways. The etiology of TOP remains obscure. Various etiologies have been suggested, but none has been proven. Clinical features of the disease are usually insidious, causing delayed recognition. Symptoms consist of gradually increasing dyspnea, hoarseness, cough, and expectoration, depending on the degree of respiratory obstruction. We suggest that CT demonstration of multiple endotracheal nodules with calcification is so characteristic for TOP that it should be the primary diagnosis, particularly in the presence of a subglottic stenosing lesion.