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LETTER TO THE EDITOR
Year : 2012  |  Volume : 5  |  Issue : 2  |  Page : 166-167  

Incidental tracheo-bronchial calcification


1 Department of Neurosurgery, Narayana Medical College Hospital, Chinthareddypalem, Nellore, Andhra Pradesh, India
2 Department of Emergency Medicine, Narayana Medical College Hospital, Chinthareddypalem, Nellore, Andhra Pradesh, India

Date of Web Publication10-Nov-2012

Correspondence Address:
Amit Agrawal
Professor of Neurosurgery, Department of Neurosurgery, Narayana Medical College Hospital, Chinthareddypalem, Nellore - 524003, Andhra Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0975-2870.103353

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How to cite this article:
Agrawal A, Kumar SS, Raghu K, Singh SP. Incidental tracheo-bronchial calcification. Med J DY Patil Univ 2012;5:166-7

How to cite this URL:
Agrawal A, Kumar SS, Raghu K, Singh SP. Incidental tracheo-bronchial calcification. Med J DY Patil Univ [serial online] 2012 [cited 2017 May 23];5:166-7. Available from: http://www.mjdrdypu.org/text.asp?2012/5/2/166/103353

Sir,

Incidental detection of tracheobronchial abnormalities on routine imaging and familiarity with their appear­ances is important to improve diagnosis and patient care. [1] A 65-year-old female patient was admitted with a diagnosis of left fronto-parietal intracerebral hematoma. She was not a known diabetic and hypertensive. Her chest X-ray showed extensive calcification of trachea and main bronchus [Figure 1]. Blood investigations were normal. The patient required tracheostomy and it could be done without complications. Blood investigations including serum calcium were within normal range. She made uneventful recovery. Diffuse tracheobronchial calcifi­cation observed on plain chest radio­graphs is said to be a result of aging. [2] Diffuse tracheobronchial calcifi­cation at radiography most commonly occurs in patients of advanced age [3],[4] and is more frequent in females. [2] In a series of 1152 patients, extensive tracheobronchial calcification was identified in 0.87% of X-rays. [5] Rare causes of focal tracheobronchial cartilage calcification include congenital, [6] following cardiac surgery in children, [7] in patients with hypercalcaemia and hyperphosphataemia, [8] chondrodys­plasia punctata, adrenogenital syndrome, diastrophic dysplasia [9] and in patients with long term warfarin therapy. [10] With the greater use of computed tomography (CT) scan and its more sensitivity to recognize even small amount of calcification is expected to show a higher prevalence of tracheal calcifications. [11] As was seen in the present case and also described in literature that this finding is often striking and visually re­markable; however, but is of no clinical significance. [3],[5]
Figure 1: X-ray appearance of extensive calcifi cation of the trachea and bronchus in an elderly female

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  References Top

1.Marom EM, Goodman PC, McAdams HP. Diffuse abnormalities of the trachea and main bronchi. AJR Am J Roentgenol 2001;176:713-7.  Back to cited text no. 1
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2.Fraser RG, Pare P, Pare J, Fraser R. Differential diagnosis of diseases of the chest. Saunders; 1991.  Back to cited text no. 2
    
3.Meyer CA, White CS. Cartilaginous disorders of the chest. Radiographics 1998;18:1109-23; quiz 241-2.  Back to cited text no. 3
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4.Jo SH, Choi YJ, Cho GY, Kim HS, Jung KS, Rhim CY. Tracheal calcification. CMAJ 2008;179:291.  Back to cited text no. 4
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5.Fukuya T, Mihara F, Kudo S, Russell WJ, DeLongchamp RR, Vaeth M, et al. Tracheobronchial calcification in members of a fixed population sample. Acta Radiol 1989;30:277-80.  Back to cited text no. 5
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6.Mlynarski FG, Parnes SM, Polanski S. Congenital calcification of the larynx and trachea. Otolaryngol Head Neck Surg 1985;93:99-101.  Back to cited text no. 6
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7.Rifkin MD, Pritzker HA. Tracheobronchial cartilage calcification in children. Case reports and review of the literature. Br J Radiol 1984;57:293-6.  Back to cited text no. 7
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8.Onitsuka H, Hirose N, Wantanabe K, Nishitani H, Kawahira K, Matsuura K, et al. Computed tomography of tracheopathia osteoplastica. AJR Am J Roentgenol 1983;140:268-70.  Back to cited text no. 8
    
9.Moncada RM, Venta LA, Venta ER, Fareed J, Walenga JM, Messmore HL. Tracheal and bronchial cartilaginous rings: Warfarin sodium-induced calcification. Radiology 1992;184:437-9.  Back to cited text no. 9
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10.Price PA, Faus SA, Williamson MK. Warfarin causes rapid calcification of the elastic lamellae in rat arteries and heart valves. Arterioscler Thromb Vasc Biol 1998;18:1400-7.  Back to cited text no. 10
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11.Lloyd DC, Taylor PM. Calcification of the intrathoracic trachea demonstrated by computed tomography. Br J Radiol 1990;63:31- 2.  Back to cited text no. 11
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