Tracheobronchopathia osteochondroplastica: pathological features and clinical insights of a rare airway disease — case report

Tracheobronchopathia osteochondroplastica (TO) is an uncommon benign disorder characterized by multiple submucosal osteocartilaginous nodules in the tracheobronchial tree. Due to its low incidence and nonspecific clinical presentation, TO is frequently misdiagnosed. We report a case of a 67-year-old male with chronic cough, dyspnea, and hemoptysis. Imaging studies and bronchoscopic evaluation revealed characteristic calcified nodular projections and variable airway narrowing. Histopathological examination identified mature submucosal cartilaginous and bony tissue, accompanied by hematopoietic marrow. Immunohistochemical analysis showed strong S-100 positivity in chondroid areas, diffuse vimentin reactivity in mesenchymal components, and CD43 expression in intratrabecular hematopoietic cells. The etiopathogenesis of TO remains incompletely elucidated; however, recent studies suggest aberrant differentiation of tracheobronchial basal stem cells and dysregulation of the TGF-β/BMP signaling pathway as potential mechanisms. This report emphasizes the essential role of histopathology—supplemented by immunohistochemistry—in diagnosing TO.