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Ear, Nose, & Throat Journal Mar 2022Tracheobronchopathia osteoplastica (TO) is a rare, benign disease of unknown etiology, primarily affecting the major tracheobronchial tree, characterized by irregular...
Tracheobronchopathia osteoplastica (TO) is a rare, benign disease of unknown etiology, primarily affecting the major tracheobronchial tree, characterized by irregular nodular calcifications of the cartilaginous component of the inner wall of the tracheobronchial tree while sparing the posterior wall, leading to progressive narrowing of the airway. We report the case of a 60-year-old male otherwise healthy nonsmoker, who complained of chronic breathing discomfort and recurrent chest infections and was found to have TO according to radiographic, microlaryngoscopic, and biopsy findings. He experienced a flare up with worsening of disease progression after years of being in stable condition, after his infection with SARS-CoV-2.
PubMed: 35324341
DOI: 10.1177/01455613221083822 -
Turkish Thoracic Journal Mar 2021There are various anatomic variations in the tracheobronchial system. The frequency in studies with bronchoscopy was contradictory. This study aimed to investigate the...
OBJECTIVES
There are various anatomic variations in the tracheobronchial system. The frequency in studies with bronchoscopy was contradictory. This study aimed to investigate the tracheobronchial tree of the deceased patients with anatomical dissection.
MATERIAL AND METHODS
We made anatomical dissections on 204 cases in the Council of Forensic Medicine, Ministry of Justice. The deceased patients who were older than 12 years of age and of Turkish origin were included in this study consecutively.
RESULTS
Of the 204 cases, 161 (78.9%) were males and 43 (21.1%) were females. The mean age was 44.15±19.23 years. Anatomical variations were found to be present in 200 cases (98% of total). The highest degree of variation of the right upper lobe was noted to be 16.6% (34/204). An anomalous arrangement (with three segments or different placement) of the middle lobe was noted in 16.1% of cases. For the basal lower lobe, b8+(b9+b10) pattern and basal orifice with four segments were noted to be the most frequent anatomical variant in the right and left lungs, respectively. The most frequent tracheobronchial variations were as follows: apical basal lobe with two subsegments in the right and left (39.7%), left lower lobe basal orifice with four segments (34.8%), left upper lobe with three segments (25.5%), and right lower lobe basal orifice with three main segmental bronchi (21.1%).
CONCLUSION
The tracheobronchial tree exhibits highly individualistic features. The knowledge of the frequency of different variations obtained in different studies and normal anatomic variants in return makes doing therapeutic or diagnostic interventions easier and more accurate.
PubMed: 33871335
DOI: 10.5152/TurkThoracJ.2021.18111 -
Chest Nov 2016Although mucus is a normal product of the tracheobronchial tree, some diseases of the respiratory tract are characterized by unusually thick (inspissated) forms of mucus... (Review)
Review
Although mucus is a normal product of the tracheobronchial tree, some diseases of the respiratory tract are characterized by unusually thick (inspissated) forms of mucus that accumulate within the airways. These are known as mucus plugs. The pathologic composition of these plugs is surprisingly diverse and, in many cases, correlates with distinctive clinical, radiologic, and bronchoscopic findings. The best-known conditions that involve mucus plugs are allergic bronchopulmonary aspergillosis, plastic bronchitis, and asthma. Other lung diseases occasionally associated with plugs within the airways include Aspergillus tracheobronchitis, hyper-IgE syndrome, exogenous lipoid pneumonia, pulmonary alveolar proteinosis, and chronic eosinophilic pneumonia. In this review, we describe and illustrate the bronchoscopic, pathologic, and imaging findings in respiratory disorders characterized by mucus plugs or plugs composed of other similar materials. Recognition of the characteristic appearance and differential diagnosis of mucus plugs will hopefully facilitate diagnosis and management of these diseases.
Topics: Airway Obstruction; Bronchi; Bronchoscopy; Humans; Mucus
PubMed: 27445091
DOI: 10.1016/j.chest.2016.07.003 -
Medicine Oct 2022Bronchial schwannomas are extremely rare among the benign tracheobronchial tumors and little are known about its epidemiology and optimal clinical management. Here, we... (Review)
Review
RATIONALE
Bronchial schwannomas are extremely rare among the benign tracheobronchial tumors and little are known about its epidemiology and optimal clinical management. Here, we report a case of bronchial schwannoma in a young Japanese man and clinical implications about epidemiology, symptom, diagnosis, and treatment of bronchial schwannoma.
PATIENTS CONCERN
A 37-year-old man visited our department with a nodule incidentally found on his chest radiograph during a routine medical checkup.
DIAGNOSIS
The tumor was diagnosed as a bronchial schwannoma after pathological evaluation. Microscopically, the tumor consisted of spindle cell proliferation characterized by an alternating highly ordered cellular Antoni A component with occasional nuclear palisading and a loose myxoid Antoni B component. Tumor cells were immunoreactive for S100 but not for smooth muscle actin or KIT.
INTERVENTIONS
A video-assisted right middle and lower bilobectomy was performed.
OUTCOME
He remains under observation without recurrence.
LESSONS
In our review, many reports have come from Asian countries. Bronchial schwannoma can occur within a wide range of age groups and in both men and women. No difference in incidence was observed between right and left bronchial tree. Bronchial schwannoma is sometimes difficult to differentiate from malignant diseases. We should include bronchial schwannoma as one of the differential diagnoses of primary bronchial tumors.
Topics: Actins; Adult; Bronchial Neoplasms; Diagnosis, Differential; Female; Humans; Male; Neurilemmoma; Pneumonectomy
PubMed: 36221358
DOI: 10.1097/MD.0000000000031062 -
California Medicine May 1959Mediastinal emphysema may occur due to migration of air from the lungs, from the esophagus or tracheobronchial tree and from the abdomen. Of especial interest is the...
Mediastinal emphysema may occur due to migration of air from the lungs, from the esophagus or tracheobronchial tree and from the abdomen. Of especial interest is the mechanism starting with the rupture of the perivascular alveoli due to a rapid decrease in intrathoracic pressure from any cause, the development of pulmonary interstitial emphysema and migration of the air into the mediastinum. In one case the patient had severe interstitial emphysema of the left lung, mediastinal emphysema and subcutaneous emphysema without pneumothorax and rapid improvement followed tracheotomy. In another case the patient had interstitial emphysema of the left lung that did not progress to mediastinal emphysema and subcutaneous emphysema. Pneumothorax was not present. Recovery was more rapid than in the first patient.
Topics: Abdominal Cavity; Esophagus; Humans; Lung; Mediastinal Emphysema; Mediastinum; Medical Records; Pneumothorax; Pressure; Pulmonary Alveoli; Pulmonary Emphysema; Rupture; Subcutaneous Emphysema; Thorax; Tracheotomy; Viscera
PubMed: 13651959
DOI: No ID Found -
Scientific Reports Jun 2022The tracheobronchial tree is commonly seen to have a systematic branching symmetry, despite being known to have an asymmetrical design. Branching asymmetry allows for...
The tracheobronchial tree is commonly seen to have a systematic branching symmetry, despite being known to have an asymmetrical design. Branching asymmetry allows for uniform airflow and provides robustness against the morphogenesis-related size variability. Here, a constructal approach is used to tracheobronchial tree analysis, and a general model based on entropy generation during breathing process is provided, which holds with asymmetric characteristics of the tree, and the change for inhaling and exhaling air. In contrast to traditional models available in the literature, the entropy generation of inspiration and expiration processes is compared for symmetry and asymmetric designs. This approach unravels the fundamental consequences of asymmetric constraint in the process of breathing and provides justification for the tracheobronchial tree having the same number of bifurcation levels as optimized symmetrical trees.
Topics: Bronchi; Entropy; Exhalation; Lung; Models, Biological; Morphogenesis
PubMed: 35710699
DOI: 10.1038/s41598-022-14072-6 -
Pulmonary Medicine 2014Despite the rapid advancement in diagnostic and therapeutic modalities, endobronchial tuberculosis (EBTB), defined as tuberculous infection of the tracheobronchial tree,... (Review)
Review
Despite the rapid advancement in diagnostic and therapeutic modalities, endobronchial tuberculosis (EBTB), defined as tuberculous infection of the tracheobronchial tree, continues to remain challenging for clinicians. Nonspecific respiratory symptoms along with normal chest radiograph in 10-20% of cases may be alleged for the diagnostic delay. Variable diagnostic yield with sputum microscopy might further compound the problem. In such cases, high resolution computed tomography (HRCT) works as a more sensitive tool and demonstrates involvement of tracheobronchial tree described classically as "tree-in-bud" appearance. Bronchoscopic biopsy is considered the most reliable method for confirmation of the diagnosis with 30% to 84% positivity in different series. Evolution of the disease is also unpredictable with frequent progression to bronchostenosis, therefore requiring regular follow-up and early intervention to halt the natural course. This review article elaborates various aspects of the disease with specific focus on diagnostic dilemma and recent advances in interventional bronchoscopy. In addition, this discussion evokes optimism for further research and introduction of innovative therapeutic modalities.
Topics: Antitubercular Agents; Bronchi; Bronchoscopy; Humans; Prognosis; Sputum; Tomography, X-Ray Computed; Tuberculosis, Pulmonary
PubMed: 25197570
DOI: 10.1155/2014/594806 -
Comparative Medicine Aug 2023Swine are commonly used for research on the respiratory system, but various anatomic features of the tracheobronchial tree of swine are poorly defined. The purpose of...
Swine are commonly used for research on the respiratory system, but various anatomic features of the tracheobronchial tree of swine are poorly defined. The purpose of our study was to acquire normative measurements of the tracheobronchial tree of swine by using chest CT scans, thus laying a foundation for treating or studying airway disorders in this species. In our study, 33 male swine underwent thoracic CT scans; we measured anatomic features of the tracheobronchial tree, including the diameter, length, and angle of various airway structures. We further analyzed the relationships among selected principal parameters. Our data revealed several similarities and differences in anatomy between swine and humans. This information may be useful in future research.
Topics: Humans; Animals; Swine; Bronchi; Tomography, X-Ray Computed
PubMed: 37817365
DOI: 10.30802/AALAS-CM-22-000101 -
Jornal Brasileiro de Pneumologia :... 2007Benign tracheal tumors are rare, recurrent papillomatosis being the most common. They often simulate obstructive pulmonary diseases, such as asthma and chronic...
Benign tracheal tumors are rare, recurrent papillomatosis being the most common. They often simulate obstructive pulmonary diseases, such as asthma and chronic obstructive pulmonary disease, and patients with benign tracheal tumors often undergo long-term treatment for such diseases, without any improvement, Therefore, these tumors should be included in the differential diagnosis in patients presenting tracheobronchial tree obstruction. This report describes the case of a patient with a tracheal polyp. The patient presented symptoms for three years, and the spirometry findings suggested intrathoracic obstruction. The patient presented complete clinical and spirometric recovery after bronchoscopic resection of the tumor.
Topics: Asthma; Bronchoscopy; Diagnosis, Differential; Humans; Male; Middle Aged; Polyps; Spirometry; Tracheal Neoplasms
PubMed: 18026663
DOI: 10.1590/s1806-37132007000500020 -
Biomedical Engineering Online Oct 2019Pulmonary lobectomy has been a well-established curative treatment method for localized lung cancer. After left upper pulmonary lobectomy, the upward displacement of...
BACKGROUND
Pulmonary lobectomy has been a well-established curative treatment method for localized lung cancer. After left upper pulmonary lobectomy, the upward displacement of remaining lower lobe causes the distortion or kink of bronchus, which is associated with intractable cough and breathless. However, the quantitative study on structural and functional alterations of the tracheobronchial tree after lobectomy has not been reported. We sought to investigate these alterations using CT imaging analysis and computational fluid dynamics (CFD) method.
METHODS
Both preoperative and postoperative CT images of 18 patients who underwent left upper pulmonary lobectomy are collected. After the tracheobronchial tree models are extracted, the angles between trachea and bronchi, the surface area and volume of the tree, and the cross-sectional area of left lower lobar bronchus are investigated. CFD method is further used to describe the airflow characteristics by the wall pressure, airflow velocity, lobar flow rate, etc. RESULTS: It is found that the angle between the trachea and the right main bronchus increases after operation, but the angle with the left main bronchus decreases. No significant alteration is observed for the surface area or volume of the tree between pre-operation and post-operation. After left upper pulmonary lobectomy, the cross-sectional area of left lower lobar bronchus is reduced for most of the patients (15/18) by 15-75%, especially for 4 patients by more than 50%. The wall pressure, airflow velocity and pressure drop significantly increase after the operation. The flow rate to the right lung increases significantly by 2-30% (but there is no significant difference between each lobe), and the flow rate to the left lung drops accordingly. Many vortices are found in various places with severe distortions.
CONCLUSIONS
The favorable and unfavorable adaptive alterations of tracheobronchial tree will occur after left upper pulmonary lobectomy, and these alterations can be clarified through CT imaging and CFD analysis. The severe distortions at left lower lobar bronchus might exacerbate postoperative shortness of breath.
Topics: Bronchi; Computer Simulation; Humans; Hydrodynamics; Lung Neoplasms; Pressure; Tomography, X-Ray Computed; Trachea
PubMed: 31653252
DOI: 10.1186/s12938-019-0722-6