Key differences between tracheobronchial diseases
Granulomatosis with polyangiitis | Tracheobronchial amyloidosis | Tracheopathia osteochondroplastica | Tracheobronchial papillomatosis | Relapsing polychondritis | |
Cause | Vasculitis of uncertain cause (probable hypersensitivity reaction) | Idiopathic or associated with various inflammatory, hereditary or neoplastic pathogens | Idiopathic benign disease | Infection of the upper respiratory tract by the human papillomavirus | Autoimmune |
Radiology | Circumferential mucosal thickening of the trachea and central bronchi; may appear with subglottic stenosis | Circumferential nodular or regular thickening of trachea, central bronchi and pharynx; may have calcification | Usually calcified nodules sparing the posterior wall of the trachea; frequently in the inferior two-thirds of the trachea and proximal bronchi | Multiple non-calcified polypoid lesions narrowing the airway; more frequent in larynx; rarely affects small airways | Regular thickening sparing the posterior wall of the trachea; affects upper trachea and larynx most frequently |
Presentation | Glomerulonephritis, systemic vasculitis, oral ulcer, myalgias; respiratory symptoms usually appear later | Asymptomatic, dyspnoea, cough, recurrent infection, wheezing; variable symptoms according to affected organ | Asymptomatic, cough, dyspnoea, recurrent infection, wheezing, haemoptysis | Hoarseness, choking episodes, cough, dyspnoea, stridor | Auricular and nasal chondritis, ocular inflammation, polyarthritis, audio vestibular damage, tracheomalacia |
Histology | Mucosal and submucosal inflammatory infiltrate and ulcer; poorly formed granulomas | Submucosal deposits of proteinaceous material (amyloid) that stain with Congo red | Submucosal osteocartilaginous nodules; may display a connection to the perichondrium of a tracheal ring | Mild to moderate dysplasia; papillomatosis and basal hyperplasia | Inflammation and destruction of the cartilaginous rings |