trachea

1. TRACHEAL DISORDERS
Dr.JINO JUSTIN.J
RADIOLOGY RESIDENT
RMMCH

2. TRACHEA
The trachea is a cylindrical tube that projects onto the spine
from C6 to the level of T5.
As it passes downwards, it follows the curvature of the spine,
and courses slightly backward.
Near the tracheal bifurcation, it deviates slightly to the right.
The subglottis ends 2 cm below the level of the vocal cords.
This corresponds cranially to the inferior margin of the cricoid
cartilage, which is the inferior margin of the larynx and forms
the only complete cartilage ring in the airway.

3. • 18-22 cartilaginous rings
• There are 2.1 rings/cm
• Becomes intrathoracic at
6th cartilaginous ring
• Length 9 -17 cm
• Intrathoracic portion: 6-
15 cm
• Cross-section area of
women about 40%
less than men.

4. The membranous posterior membrane allows
esophageal expansion during deglutition
Contains
glands, small
arteries,
nerves, lymph
vessels and
elastic fibers
Trachealis
muscle overlies
esophageal
muscle and
epithelium

5. Tracheal dimensions
Trachea
– Average cross-sectional
area of the male adult
trachea is approximately 2.8
cm2
– Transverse (lateral) diameter is
of 25 mm and sagittal diameter
is of 27 mm are the upper limits
of normal (males)
– The lower limit is normal for both
transverse and sagittal diameters
& it is about 13 mm in men and
10 mm in women

6. Some facts about tracheal anatomy
 The cervical segment (extrathoracic) ends at the
sternal manubrium and encompasses about the
first six tracheal rings.
 The U-shaped trachea is probably the most
frequent shape found.
 A man’s cross sectional tracheal area is usually
about 40 percent larger than a woman’s.

7. The trachea is lined by ciliated columnar epithelium.
The trachea in children is very pliable. It may be
deviated to the right at almost 90° in a normal
expiratory film.
It only deviates to the left if the aortic arch is on the
right side.

8. •Relations of the trachea
•CERVICAL
The anterior relations are as
follows:
•Anterior:
Isthmus of thyroid anterior to
the second, third and fourth rings
Inferior thyroid veins
Strap muscles: Sternohyoid and
Sternothyroid
•Posterior:
Oesophagus
Recurrent laryngeal nerves
Lateral:
Lobes of thyroid gland
Common carotid artery.

9. Thoracic:
The thoracic relations are as follows:
• Anterior:
Brachiocephalic and left common carotid arteries
Left brachiocephalic vein
• Posterior: Oesophagus and left recurrent
laryngeal nerve
• Left lateral:
 Arch of the aorta
Left common carotid and left subclavian arteries
• Right lateral: Right brachiocephalic artery
Right vagus nerve
Arch of the azygos vein
Pleura (in direct contact unlike the other side).

10. •BLOOD SUPPLY OF THE TRACHEA
The upper trachea is supplied by the inferior
thyroid artery and the lower part is supplied
by branches of the bronchial artery.
Venous drainage is to the inferior thyroid
venous plexus.

11. Mediastinal lymph nodes that drain the lung are named according to their
position:
Tracheobronchial nodes above the tracheobronchial junction
Right and left paratracheal nodes on either side of the trachea.

12. The trachea is seen as a midline
translucency with a slight inclination to the
right in its lower half.
Its lumen is 1.5-2 cm in diameter.
The right paratracheal stripe (normally < 3
mm) is formed by the right wall of the
trachea and the pleura, outlined on both
sides by air.
The left side of the trachea is not seen
separately from the mediastinal shadows.
A smooth indentation on the trachea is
commonly seen just above the bifurcation on
the left side. This is caused by the arch of the
aorta.

13. RADIOLOGICAL FEATURES OF
TRACHEA ON LATERAL CHEST
RADIOGRAPH
On a lateral chest radiograph the trachea is seen to enter the thorax midway
between the sternum and the vertebrae.
Owing to some posterior inclination it ends closer to the vertebrae.
The posterior paratracheal stripe is formed by the posterior wall of the trachea
and the pleura and is visible if the lung passes behind the trachea.
The tracheo-oesophageal stripe is formed by the posterior wall of the trachea
and the anterior wall of the oesophagus.
It is visible if there is air in the oesophagus.

14. Disorders
• CONGENITAL ABNORMALITIES.
• TRACHEAL NARROWING.
• TRACHEAL WIDENING.
• TRACHEAL AGENESIS.
• TRACHEAL STENOSIS.
• TRACHEOMALACIA.
• Tracheobronchopathia Osteochondroplastica.
• Neoplasm

15. CONGENITAL ABNORMALITIES
• TRACHEOESOPHAGEAL FISTULA.
– USUALLY OCCURS IN ASSOCIATION WITH ESOPHAGEAL ATRESIA,CAN ALSO
OCCUR AS AN ISOLATED ANOMALY.
– MAY ALSO BE ASSOCIATED WITH OTHER ABNORMALITIES LIKE
– DUE TO FAILED FUSION OF TRACHEO ESOPHAGEAL RIDGES during third week
of embryological development.
– Commonly associated with vater complex
– VERTEBRAL.
– ANAL.
– TRACHEO-OESOPHAGEAL.
– RENAL.

16. TYPES
• Type 1-esophageal agenesis{very rare}.
• Type 2-proximal and distal esophageal bud
present,with a missing mid-segment.
• Type 3-3A,3B&3C.
• 3A-proximal esophageal termination on the
lower trachea with distal esophageal bud.
• 3B-proximal esophageal atresia with distal
end arising from the lower trachea or
carina.(most common upto 90%of cases).
• 3C-proximal esophageal termination on the
lower trachea or carina with distal
esophagus arising from the carina.
• Type D-if two segments of esophagus
communicates ,termed as H type
fistula(resemblane of the letter H).

18. TRACHEAL AGENESIS
• Very rare and commonly associated with
maternal polyhydramniaos.
 C/F : Acute severe respiratory distress, absent
cry, inability to intubate.

19. • Type 1 – Absent upper
trachea with lower trachea
connecting to the
oesophagus
• Type 2 – Common bronchus
connecting right and left
main bronchi to oesophagus
with absent trachea
• Type 3 -Right and left main
bronchi arises
independentaly from
oesophagus

20. TRACHEAL NARROWING
• Other wise known as sub-glottic stenosis(just below the vocal cord).
• In babies and young children subglottis is the narrowest part of the airway
and most stenosis do occur at this level.
• CAUSES
• Fibrosing Mediastinitis
• Post tracheostomy(most common).
• Wegeners granulomatosis.
• Idiopathic progressive sub-glottic stenosis.
• Amyloidosis.
• Benign tumors e.gCarcinoid.
• Tracheal trauma/rupture.

21. FIBROSING MEDIASTINITIS
• Usually occurs due to tuberculosis
and histoplasmosis causing tracheal
narrowing Fibrosing Mediastinitis –
Coronal CT Image
• There is airway narrowing of the right
lower lobe bronchus. There is
thickening of the right pleura and
right interlobular septae. There are
partially calcified right hilar and
mediastinal lymph nodes

22. TRACHEOBRONCHOPATHIA
OSTEOCHONROPLASTICA
• rare, benign disease
• characterized by development of cartilaginous and osseous
nodules within submucosa of the tracheal and bronchial walls.
• typical in men > 50yrs
• C/F - incidental finding mostly.
- dyspnea, cough, hemoptysis&wheezing
may be present.
- Nodules tend to be localized to the submucosa directly
associated with the tracheal cartilage, sparing the posterior
tracheal membrane .

23. • The nodules - 3 - 8 mm in diameter
usually calcified.
• irregular than normal cartilage calcification.
• Similar central bronchial calcification also is
seen in many patients.
• No significant decrease in tracheal diameter is
seen with forced expiration.

24. CT image at two levels shows nodular
thickening and calcifi cation of the anterior and
lateral tracheal wall. The posterior tracheal
mem-brane is normal in thickness and devoid
of calcifi cations
Diagrammatic representation of
the appearance of the trachea in
tracheobronchopathia
osteochondroplastica. Tracheal
cartilages are thickened, with small
irregular calcifi c nodules along
their inner aspect, protruding into
the tracheal lumen.

25. nodules arising from the anterior and lateral
tracheal wall, projecting into the lumen. The
nodules are uncalcified.
Bronchoscopy shows nodules
arising from tracheal
cartilage. The posterior
trachea is normal.

26. Tracheal Stenosis
• Congenital tracheal stenosis may result from a ring-shaped tracheal
cartilage.
• Acquired tracheal stenosis usually is due to prior intubation or
tracheostomy.
• Progressive dyspnea following extubation typically is present.
• Infl ammation and pressure necrosis of the tracheal mucosa most
commonly occur at either the tracheostomy stoma or at the level of the
tube balloon, 1 to 1.5 cm proximal to the tube tip; the stenosis usually
involves 1.5 to 2.5 cm of the tracheal wall.
• The extrathoracic trachea most often is involved.
• Focal narrowing may be seen if the tube tip presses on one part of the
tracheal wall, usually the anterior wall.
• Acute postintubation stenosis results from edema of the tracheal wall or
intraluminal granulation tissue.
.

27. • Plain films - may show an eccentric or hourglass-shaped
tracheal nar-rowing.
• On CT, this may be seen as eccentric or
concentric soft tissue internal to normal-appearing
tracheal cartilage. The outer tracheal
wall has a normal appear-ance, without evidence
of deformity or narrowing. Dynamic expiratory
images show little change in tracheal dimensions.
• Acute and chronic stenosis may also result from
sarcoidosis, histoplasmosis, Wegener’s
granulomatosis, and ulcerative colitis.

28. Postintubation tracheal stenosis due to granulation tissue.
A: Near the thoracic inlet, the trachea appears normal
B: Below the level shown in (A), focal narrowing of the tracheal lumen is
associated with increased soft tissue (white arrows) within the tracheal
lumen. The calcified tracheal cartilage (black arrows) appears normal,
without evidence of deformity or collapse.

29. Coronal reconstruction in a patient with an hourglass-shaped tracheal
stenosis following intubation. The tracheal wall appears normal (large
arrows), and granulation tissue is seen narrowing the tracheal lumen (small
arrows).

30. Postintubation tracheal stenosis due to stricture
CT image at two levels shows side-to-side
narrowing of the tracheal lumen resulting from
deformity of the tracheal cartilage (arrows).

31. Postintubation tracheal stenosis due to deformity of tracheal cartilage
CT shows side-to-side narrowing of the tracheal lumen resulting from deformity of the
tracheal cartilage (arrows). The tracheal wall is outlined by mediastinal fat.
B: Coronal reconstruction shows an hourglass-shaped stenosis, with inward collapse of
the tracheal wall (white arrows). Calcifi ed tracheal cartilage (black arrow) is displaced
inward.
C: Three-di-mensional reconstruction shows the hourglass-shaped stenosis.

32. AMYLOIDOSIS
• rare
• Symptoms - hoarseness, stridor, dyspnea, cough, hemoptysis, and
recurrent infections.
• Primary tracheobronchial amyloidosis - usually confined to the airways,
with no evidence of concurrent parenchymal disease.
• Deposits are multifocal or diffuse
submucosal in location
involve the length of the trachea
main bronchi also are commonly affected.
• plain radiographs and CT
diffuse tracheobronchial amyloidosis usually leads to concentric or
nodular thickening of the tracheal wall
Calcication or ossification is common.
Malacia is not present.
Rarely, a single localized submucosal nodule is present, resulting in
eccentric wall thickening.
Multiple isolated lesions also may be seen.
Atelectasis may be associated with bronchial involvement.

33. • Tracheobronchial amyloidosis. CTs through the proximal trachea using lung
(A) and soft tissue (B) windows show eccentric thickening of the tracheal
wall (arrows)

34. CT shows nodular thickening and calcifi cation of the walls of the right
main and right upper lobe bronchi (arrows). D: Coronal reforma-tion
shows tracheal wall thickening (large arrows) and focal thickening and
calcifi cation of bronchial walls (small arrows). Lymph node calcifi cation
also is visible

35. WEGENER’S GRANULOMATOSIS
• systemic vasculitis.
• 90% of cases, serum antineutrophil cytoplasmic antibodies
characterized by a diffuse granular cytoplasmic immunofl
uorescent staining pattern (cytoplasmic antineutrophil
cytoplasmic antibody [C-ANCA]) are present.

36. • tracheobronchial involvement - 15% to 25% of cases;
• symptoms - hoarseness, cough, and stridor.
• Subglottic tracheal involvement is most typical
• variable involvement of the vocal cords, distal trachea, and
proximal main stem bronchi.
• Abnormalities may be focal or diffuse.
• Pathologic findings -
circumferential airway wall thickening and inflammation,
concentric narrowing of the tracheal lumen;
mucosal ulceration and destruction of the cricoid or
tracheal cartilage are less common.
• Plain radiographs - tracheal narrowing on both the frontal
and lateral radiographs; this narrowing may be localized or
diffuse.

37. CT findings
• focal or circumferential thickening of the tracheal wall
• an increase in the overall tracheal diameter due to wall thickening
• narrowing of the tracheal lumen
• Malacia may be present
• Proximal bronchi may be involved

38. • Subglottic tracheal stenosis in Wegener’s
granulomatosis. A: Excessive soft tissue (arrows) is
visible internal to the cricoid cartilage. B: Coronal
reconstruction in subglottic stenosis due to Wegener’s
granulomatosis. The focal narrow-ing (large arrows) is
just below the level of the vocal cords (small arrows).

39. • Tracheal and bronchial narrowing in Wegener’s granulomatosis. A: Chest
radiograph shows bilateral lung nodules (arrows)..B: CT shows tracheal narrowing
associated with concentric thickening of the tracheal wall (arrows).

40. Tracheal and bronchial narrowing in Wegener’s
granulomatosisC: At the level of the carina,
bronchial wall thickening (arrow) also is seen

41. • Tracheomalacia in Wegener’s granulomatosis. A: CT image on
inspiration shows the tracheal lumen to be slightly reduced in
diameter. B: CT during dynamic forced expiration shows marked
reduction in the tracheal lumen.

42. • Bronchial narrowing in Wegener’s granulomatosis. A: CT shows narrowing
of the proxi-mal left main bronchus, associated with thickening of its wall
(arrows). B: Three-dimensional recon-struction shows left main bronchus
narrowing (arrows). The distal trachea is slightly narrowed.

43. SABER SHEATH TRACHEA
• almost always is associated with chronic obstructive
pulmonary disease.
• characterized by marked decrease in the coronal diameter
of the intrathoracic trachea associated with an increase in
its sagittal diameter
• extrathoracic trachea is normal.
• may involve the entire intrathoracic trachea
• earliest stages it is visible only at the thoracic inlet.
• thought to be due to chronic injury and malacia of tracheal
cartilage due to coughing or increased intrathoracic
pressure.
• The main bronchi are of normal size.

44. • On frontal radiographs
a characteristic side-to-side narrowing of the tracheal lumen is visible
beginning at the thoracic inlet
The right paratracheal stripe, primarily representing tracheal wall,
appears normal or slightly increased in thickness.
• On the lateral radiograph
the tracheal diameter appears normal or slightly increased.
tracheal diameter on the lateral fi lm measures 1.5 times that seen on
frontal fi lm, saber sheath trachea is considered to be present

45. CT
• inward displacement of the lateral portions of the tracheal
wall and cartilage with side-to side narrowing of the lumen
• tracheal wall usually normal thickness.
• During forced expiration - further inward bowing of the
tracheal walls in many patients.

46. Saber-sheath trachea in a patient with chronic obstructive
pulmonary disease
• PA chest radiograph - hourglass-shaped narrowing of the intrathoracic trachea
(black arrows). The extrathoracic trachea (white arrows) appears normal.
• lateral projection- the tracheal diameter appears increased (arrows).

47. SABER SHEATH –TRACHEA ON CT
• The extrathoracic trachea is normal.
• tracheal cartilage is calcified

48. • The intrathoracic trachea at two levels is markedly narrowed from
side to side (arrows), with deformity of the tracheal cartilage.
• The sagittal tracheal diameter is increased.
• The tracheal wall is otherwise normal in appearance.

49. RELAPSING POLYCHONDRITIS
• rare systemic disorder
• characterized by recurrent episodes of cartilage inflammation
• most commonly affecting the ear, nose, joints, and the
laryngeal and tracheal cartilage
• The upper airways are affected >50% of cases
• recurrent pneumonia is most common cause of death.
• Diffuse tracheal involvement, characterized by a dense
inflammatory exudate, is limited to the cartilage and
perichondrium
• does not affect the mucosa or submucosa.

50. • Plain radiographs
cylindrical narrowing of the extrathoracic and intrathoracic trachea and main
bronchi
• CT
thickening of the anterior and lateral tracheal wall
the posterior membrane is of normal thickness
inner and outer margins of the thickened tracheal walls are smooth in contour.
Collapse of tracheal cartilage may be seen in chronic disease.
Narrowing of both the tracheal lumen and the main bronchi is often present.
Tracheomalacia is often present

51. Relapsing polychondritis. Chest radiograph
shows cylindrical narrowing of the entire
trachea (arrows).

52. Relapsing polychondritis. The anterior and lateral tracheal walls (i.e., the
cartilaginous portions) are thickened (large arrows). The posterior tracheal
membrane is of normal thickness (small arrow). This appearance is
characteristic. B: Narrowing of the main bronchi also is seen. The anterior
bronchial walls are thickened (large arrows), while the posterior wall of the
bronchus appears normal (small arrow)

53. RELAPSING POLYCHONDRITIS
CT shows marked narrowing of the tracheal
lumen, with typical thickening of the anterior
and lateral tracheal walls.

54. RELAPSING POLYCHONDRITIS
Coronal reconstruction shows diffuse
narrowing of the trachea with thickening of its
lateral walls (arrows). Sagittal reformation
shows diffuse narrowing of the trachea
(arrows)

55. Relapsing polychondritis with
tracheomalacia. Expiratory CT
shows sig-nifi cant collapse of
the tracheal lumen compared
with an inspiratory scan .

56. TRACHEAL DIVERTICULUM
• focal herniation of tracheal mucosa through the tracheal
wall.
• may be seen in normal subjects, although it tends to be
associated with chronic obstructive pulmonary disease.
• usually is asymptomatic and is detected incidentally.
• almost always occurs near the thoracic inlet, along the
posterolateral right trachea, between the cartilaginous and
muscular portions of the tracheal wall
• Can appear as an isolated paratracheal air cyst , usually a
few millimeters in diameter, or as an airfilled structure
communicating with the tracheal lumen
• Tracheal diverticulum is easily seen on CT, but is rarely
visible on plain radiographs.

57. Heal diverticulum in a patient with chronic
obstructive pulmonary disease. A defect in the
right posterolateral tracheal wall (small arrow)
communicates with a small diverticulum (large
arrow).

58. A paratracheal air cyst is
present in the upper
mediastinum, representing a
diverticulum (arrow).
A defect in the right
posterolateral tracheal wall
(arrow) communicates with
the diverticulum.

60. MOUNIER-KUHN SYNDROME
(TRACHEOBRONCHOMEGALY)
• It is Common in men in third and
fourth decades
Tracheobronchomegaly refers to
patients who have marked dilatation
of the trachea and mainstem bronchi.
• It is often associated with tracheal
diverticulosis, recurrent lower
respiratory tract infection and
bronchiectasis.
• Atrophy affects the elastic and
muscular elements of both the
cartilaginous and membranous parts
of the trachea. The diagnosis is based
on radiological findings. The
immediate subglottic trachea has a
normal diameter, but it expands as it
passes to the carina and this
dilatation often continues into the
major bronchi.

61. Primary malignant Tracheal Tumors
• Most common (85% of cases)
Squamous cell carcinoma
Adenoid cystic carcinoma
• Rare
Other types of bronchogenic carcinoma
Carcinoid tumor
Sarcoma
Lymphoma
Metastatic
• Direct invasion most common
Thyroid carcinoma
Laryngeal cancer
Lung cancer
Esophageal cancer
• Hematogenous metastases
Melanoma
Breast carcinoma
Colon carcinoma
Kidney carcinoma
Benign
Squamous cell papilloma
Papillomatosis
Hamartoma
Mesenchymal tumors

62. TUMOURS
• Benign
-It present as small, well defined intraluminal
nodules
-papilloma,
fibroma,chondroma,haemangioma

63. • Malignant
-Usually occurs close to the carina
-Mostly squamous,adenoid cystic or
adenocarcinoma
-Extraluminal best assessed by CT finding

64. Squamous
cell
carcinoma
• associated with smoking
• multifocal in 10% of cases
• often involving the distal trachea; a
main bronchus also may be involved

65. Adenoid cystic carcinoma
• originates from tracheal mucous glands
• most common in the upper trachea
• less common than squamous cell carcinoma.
• often arises from the posterolateral tracheal wall

66. Adenoid cystic carcinoma of the proximal tra-chea.
An eccentric narrowing (arrows) of the
tracheal lumen is caused by a sessile mass
arising from the right tracheal wall.

67. • Adenoid cystic carcinoma of the
trachea. A large mass (large
arrows) in the upper trachea
markedly narrows the tracheal
lumen (small arrow) and invades
the medi-astinum
• On a sagittal
reconstruction, the mass
(arrows) can be seen to
arise from the posterior
tracheal wall. This location
is typical of adenoid cystic
carcinoma.

68. On CT
• a primary malignant tracheal tumor may appear as polypoid lesion, a focal sessile
lesion, eccentric narrow-ing of the tracheal lumen, or circumferential wall
thickening
• Attachment to the tracheal wall may be either broad based or narrow and
pedunculated.
• CT may underestimate the longitudinal extent of the tumor; submucosal spread
may be difficult to see on CT.
• However, CT is superior to bronchoscopy in evaluating extraluminal spread and the
trachea distal to an obstructing lesion.

69. Adenoid cystic carcinoma results in a sessile
mass (M) arising from the posterior tracheal
wall and protruding into the tracheal lumen.
The mass extends into the adjacent
mediastinum (arrows).
CT appearances of primary
tracheal tumor. A: Tracheal
malignancies may appear
polypoid, sessile, or
circumferential

70. Metastases
• Metastases to the trachea may occur via direct extension or by
hematogenous spread.
• Direct extension to involve the trachea most often is secondary to a
primary tumor of the lung, larynx, esophagus, or thyroid.
• These tumors may compress the trachea, displacing tracheal cartilage
inward, or may invade the tracheal lumen, with tumor being seen as
abnormal tissue internal to tracheal cartilage .
• Hematogenous metastases usually originate from melanoma, or from
carcinomas of the breast, colon, or kidney.
• On CT, hematogenous metastases may appear as single or multiple, sessile
or pedunculated endotracheal lesions

71. Tracheal metastasis. Tracheal metastases may result in
tracheal compression with inward displacement of the
tracheal wall, an endotracheal mass, or a combination of
these findings. A, B: There is narrowing of the trachea with
an endoluminal mass (arrow)
Soft-tissue window at the same
level as (B) shows a mass
involving the right tracheal wall
and mediastinal soft tissues
(arrows)

72. Squamous cell papilloma
• most common benign tracheal tumor.
• It represents an abnormal proliferation of squamous
epithelium
• may appear sessile, papillary, lobulated, or polypoid.
• Solitary papilloma is associated with smoking and is most
common in adults.
• The condition of mul-tiple papillomas (i.e., papillomatosis)
usually begins in child-hood with laryngeal involvement and is
associated with human papillomavirus infection.

73. • On CT, a solitary papilloma appears
as a well-circumscribed nodule that
is confined to the tracheal wall and
projects into the tracheal lumen;
• it often shows acute angles where it
contacts the tracheal wall.
• Tracheal cartilage is unaffected.
• Papillomatosis is characterized by
numerous nodules involving the
entire length of the trachea or
diffuse thickening of the tracheal
wall .

74. • Other benign tracheal tumors include
hamartoma and tumors of mesenchymal
origin such as lipoma or chondroma.

75. Summary
• CT is currently the primary noninvasive examination to evaluate the
trachea because it offers multiplanar capabilities, evaluates the
morphology of the tracheal wall and lumen, and can be acquired in
seconds.
• The trachea is supported by C-shaped cartilaginous rings anteriorly; the
posterior trachea is primarily supported by the thin trachealis muscle.
• The lunate-shaped trachea on inspiration is highly suggestive of
tracheomalacia.
• Traditionally, collapse of greater than 50% of the trachea during expiration
was defined as tracheomalacia; however, recent evidence suggests that
greater than 50% dynamic expiratory collapse can be seen in healthy
patients.
• In saber-sheath trachea, only the coronal diameter of the intrathoracic
trachea is narrowed; primarily men with chronic obstructive pulmonary
disease are affected.

76. • The posterior wall of the trachea and the central bronchi are classically
spared in both relapsing polychondritis and tracheobronchopathia
osteochondroplastica. However, the presence of focal coarse calcification
and ossification is highly suggestive of tracheobronchopathia
osteochondroplastica rather than relapsing polychondritis.
• Nodular calcification of the trachea is common in tracheobronchopathia
osteochondroplastica and amyloidosis. However, amyloidosis tends to
involve the airway concentrically, as opposed to tracheobronchopathia
osteochondroplastica which spares the posterior wall.
• Wegener granulomatosis most often affects the subglottic trachea but can
be diffuse or multifocal.
• Mounier-Kuhn syndrome is unique among the diffuse tracheal diseases in
that it results in diffuse airway dilatation. Diverticula project between the
cartilaginous rings giving the trachea and proximal bronchi a corrugated
appearance.

77. Thank You!

80. BOYs, C U Again in ‘IMAGING IN
GYNAEC!’