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Suspected NSCLC with mediastinal nodal disease — SCE Respiratory MCQ

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HardLung CancerSuspected NSCLC with mediastinal nodal diseaseSCE Respiratory

Bronchoscopy for recurrent lobar infection shows multiple hard whitish submucosal nodules along the anterior and lateral tracheal cartilaginous rings, extending into main bronchi while completely sparing the posterior membranous wall. Which diagnosis best fits?

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Correct answer: E — Tracheobronchopathia osteochondroplastica

Explanation lettering: E = shown as A · C = shown as B · B = shown as C · A = shown as E

A is correct. Tracheobronchopathia osteochondroplastica produces firm osteocartilaginous submucosal nodules on the anterior and lateral walls where cartilage is present, characteristically sparing the posterior membranous wall. Relapsing polychondritis causes cartilage inflammation, stenosis and malacia rather than this pebbled nodular surface. Granulomatosis and amyloidosis can be circumferential and involve the posterior wall, while dynamic airway collapse does not create hard calcified nodules.

Reference: https://pmc.ncbi.nlm.nih.gov/articles/PMC9535971/