Chronic cough with dual pathologies of pulmonary ossification

Simon Proctor, Helen Crocker, Virginia Au, Vinod Aiyappan

Research output: Contribution to journalArticlepeer-review


An 81-year-old man presented with chronic cough, which did not respond to the initiation of combined bronchodilator/inhaled corticosteroid therapy. CT of the chest revealed calcified nodules throughout the trachea sparing the posterior membrane, and tiny peripheral parenchymal nodules with basal interlobular septal thickening and calcification. Flexible bronchoscopy demonstrated endobronchial nodularity from the proximal trachea to the mid-sections of both main bronchi, sparing the posterior membrane. Histopathology revealed submucosal fibrous connective tissue and benign bone, confirming a diagnosis of tracheobronchopathia osteochondroplastica. CT was consistent with a concurrent diagnosis of dendriform pulmonary ossification. These two rare phenomena often present with non-specific symptoms, and the diagnosis can be made with imaging in both conditions. There is a role for bronchoscopy in the diagnosis of tracheobronchopathia osteochondropastica, and the endobronchial appearance could be diagnostic. The concurrence of both phenomena in our case might represent activity of a common cellular pathway of ossification in both sites.

Original languageEnglish
Article numbere243538
Number of pages4
JournalBMJ Case Reports
Issue number7
Publication statusPublished - Jul 2021
Externally publishedYes


  • radiology
  • respiratory medicine
  • Pulmonary Ossification


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