Archive of Old Cases
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Case No : 203 Date 2001-09-17
- Courtesy of Jin Mo Goo, M.D., Jung-Gi Im, M.D. / Seoul National University Hospital, Seoul, Korea
- Age/Sex 63 / M
- Chief ComplaintCough and dyspnea for one month
Discussion
Diagnosis With Brief Discussion
- Diagnosis
- Tracheobronchomegaly (Mounier-Kuhn Syndrome)
- Radiologic Findings
- Posteroanterior and lateral chest radiographs show generally increased calibers of the trachea and major bronchi. The coronal diameter of the trachea is 33 mm. Lateral chest radiograph demonstrates corrugated appearance of the trachea.
Shaded surface display and coronal reconstruction image also demonstrate tracheobronchomegaly with a large diverticulum at the thoracic inlet. - Brief Review
- Tracheobronchomegaly is a rare condition that may result in chronic obstruction. Although occasionally found in children, it usually involves males in the fourth and fifth decades and appears to be familial. Atrophy affects the elastic and muscular elements of both the cartilaginous and membranous parts of the trachea.
On radiographic study the trachea and major bronchi are noted to be increased in caliber. A coronal diameter of more than 26 mm for the trachea in men and 23 mm in women on a posteroanterior radiograph is required for the diagnosis. The trachea has an irregular, corrugated appearance caused by protrusion of the tracheal and bronchial walls between the cartilaginous rings, which is sometimes termed diverticulosis. The obstructive symptoms appear to be secondary to an inefficient cough mechanism. Most patients having this condition develop infection with associated bronchiectasis, and may succumb to infection associated with respiratory failure. The tracheal width in children with this anomaly is equal to or greater than the thoracic vertebral body width, a distinct increase in diameter. On expiration or coughing, marked tracheobronchial collapse is observed. - References
- 1. Gay S, Dee P. Tracheobronchomegaly: the Mounier-Kuhn syndrome. Br J Radiol 1984; 57: 640-644
2. Woodring JH, Howard RS, Rehm SR. Congenital tracheobronchomegaly (Mounier-Kuhn syndrome): a report of 10 cases and review of the literature. J Thorac Imaging 1991; 6: 1-10
3. Dunne MC, Reiner B. CT features of tracheobronchomegaly. J Comput Assist Tomogr 1988; 12: 388-391
4. Shin MS, Jackson RM, Ho K-J. Tracheobronchomegaly (Mounier-Kuhn syndrome): CT diagnosis. AJR 1988; 150: 777-779 - Keywords
- Airway, Congenital,
No. of Applicants : 25
- ▶ Correct Answer : 20/25, 80.0%
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- - CHU Nancy-Brabois, France Denis Regent
- - Dong-A University Hospital Ki-Nam Lee
- - IMSL, metz, France Eric Gaconnet
- - Seoul National University Hospital Tae Jung Kim
- - Stedelijk OLV Ziekenhuis Mechelen, Belgium Ivan Pilate
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