This document discusses various pathologies that can cause tracheobronchial masses or narrowing on computed tomography (CT) scans. It includes 22 figures showing examples of different diseases. Some of the pathologies shown are adherent mucus, hamartoma, papillomatosis, amyloidosis, sarcoidosis, Wegener's granulomatosis, tracheobronchopathia osteochondroplastica, squamous cell carcinoma, adenoid cystic carcinoma, metastasis, carcinoid, tuberculosis, rhinoscleroma, relapsing polychondritis, foreign body, and fibrosing mediastinitis. For each case, the CT images demonstrate the characteristic appearance of the tracheobronchial

1. 41Tracheobronchial
Mass/Narrowing on Computed
Tomography

2. CLINICAL IMAGAGING
AN ATLAS OF DIFFERENTIAL DAIGNOSIS
EISENBERG
DR. Muhammad Bin Zulfiqar
PGR-FCPS III SIMS/SHL

3. • Fig C 41-1 Adherent mucus. (A) Initial study
shows a 3-mm soft-tissue nodule (arrow)
along the left lateral tracheal wall. (B) Repeat
examination after the patient vigorously
coughed shows that the nodule is no longer
present and thus likely represented adherent
mucus.76

4. • Fig C 41-2 Hamartoma. Endobronchial
hamartoma. A mass (black arrows) of mixed
fat (white arrow) and soft-tissue attenuation
involves the right middle lobe bronchus,
resulting in atelectasis of the right middle
lobe.76

5. • Fig C 41-3 Papillomatosis. Multiple nodules
project into the tracheal lumen. There are also
multiple papillomas in the lung parenchyma.82

6. • Fig C 41-4 Amyloidosis. Diffuse circumferential thickening of the
bronchial walls bilaterally (arrows). Note the high-attenuation
regions in the bronchial walls that likely represent calcification.77

7. • Fig C 41-5 Sarcoidosis. Coronal reformatted image shows diffuse
narrowing of the left main bronchus (straight arrow) and its bifurcating
branches surrounded by conglomerate mediastinal and left hilar
adenopathy. Note occlusion of the left upper lobe bronchus (curved
arrows) by the same process. L = left main bronchus; r = right main
bronchus.77

8. • Fig C 41-6 Wegener's granulomatosis. Coronal
reformatted image shows two focal strictures (arrows)
in a diffusely narrowed left main bronchus.77

9. • Fig C 41-7 Wegener's granulomatosis.
Circumferential thickening of the tracheal
mucosa.2

10. • Fig C 41-8 Tracheobronchopathia
osteochondroplastica. Diffuse, irregular
narrowing of the trachea with calcification of the
lateral walls.82

11. • Fig C 41-9 Squamous cell carcinoma. Mass centered on
the anterior and left lateral tracheal wall (curved
arrows). Note that the lesion is disrupting the calcified
tracheal ring (straight arrow).76

12. • Fig C 41-10 Squamous cell carcinoma.
Circumferential narrowing of the left upper
lobe bronchus (arrows). e = effusion.76

13. • Fig C 41-11 Adenoid cystic carcinoma. Polypoid mass
arising from the posterolateral wall of the trachea and
protruding into the lumen.76

14. • Fig C 41-12 Metastasis. An 8-mm soft-tissue mass
(arrow) in the right main bronchus represents a
metastasis from colon carcinoma.76

15. • Fig C 41-13 Metastasis. Mass (arrowhead) in the orifice of
the left upper lobe bronchus, representing a metastasis
from renal cell carcinoma, causes collapse of the left upper
lobe (arrow). (Courtesy of Jin Hwan Kim, MD, Department
of Radiology, Chungnam National University, Taejeon,
Korea.)22

16. • Fig C 41-14 Carcinoid. Well-defined, round,
partially endobronchial nodule (arrow) in the
lateral subsegmental branch of the anterior
segmental bronchus of the left upper lobe.26

17. • Fig C 41-15 Carcinoid. Endobronchial nodule
(arrowhead) in the left basal trunk that causes
atelectasis of the left lower lobe (arrow).78

18. • Fig C 41-16 Tuberculosis. Coronal reconstruction shows
stenosis of a short focal segment (white arrow) of the
left main bronchus. Note the calcification (arrow) of a
mediastinal lymph node (black arrow). r = right main
bronchus.76

19. • Fig C 41-17 Rhinoscleroma. Circumferential
thickening of the trachea.82

20. • Fig C 41-18 Relapsing polychondritis.
Expiratory scan shows abnormal collapse of
the bronchi with air trapping in the left lung.77

21. • Fig C 41-19 Relapsing polychondritis. End-
inspiration and end-expiration scans show
dynamic collapse of the trachea with expiration
(right). Note the calcification and thickening of
the cartilaginous parts of the trachea (arrow),
with sparing of the posterior wall (arrowhead).82

22. • Fig C 41-20 Foreign body. Well-circumscribed
mass in the bronchus intermedius (arrow).76

23. • Fig C 41-21 Post-transplantation stenosis.
Focal narrowing at the anastomotic site within
the right lung in a patient who had undergone
bilateral lung transplantation.82

24. • Fig C 41-22 Fibrosing mediastinitis. Mass of soft-tissue
attenuation that diffusely infiltrates the mediastinum,
encasing and narrowing the left main bronchus (*),
ascending (A) and descending (D) aorta, proximal right
(R) and left (L) pulmonary arteries, and esophagus
(arrowhead).55