1. 5A: Abnormalities of The Trachea
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2. Bronchoscopy reports: The Trachea
The bronchoscopy report should tell a story that everyone can read and understand the same way.
Morphology: Caliber, patency, shape, normal variants
Appearance: Normal, abnormal
Mucosa: Normal, color, edematous, friable
Abnormalities: Location, type, extent, associated malacia, number of cartilaginous rings involved, posterior wall (dynamic collapse, excessive dynamic collapse)
Secretions: Abundance, location, type, color
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3. Various tracheal morphologies
Horseshoe trachea
Fixed Saber sheath (TI<0.6)
Tracheomegaly
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4. Necrotizing tracheitis
Noticed in patient while on mechanical ventilation
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5. Cartilaginous tracheal abnormalities
Bony spur
Prominent thin cartilage
Triangular (with bony spur)
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6. Osteochondroplastica*
Firm intraluminal cartilaginous nodules
* Courtesy P. Grynblatt, Argentina
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7. Osteochondroplastica benign appearance
Posterior membrane
Cartilage protuberance
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8. Infiltrative tracheal abnormalities
Amyloidosis involves larynx, trachea and carina
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9. Tracheobronchomalacia
Saber-sheath type. Note collapse of lateral walls during expiration
Crescent type. Note flattened anterior wall during expiration
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10. Tracheobronchomegaly with malacia
With chronic accumulation of purulent secretions
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11. Excessive dynamic airway collapse
Posterior wall bulges inward during expiration while anterior wall remains intact*
*Courtesy H. Dutau, France
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12. Tracheal stenosis Web-like subglottic stricture
Circumferential subglottic stenosis
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13. Pseudoglottic stenosis
Usually post tracheostomy
Fracture of cartilage
Malacia of cartilage
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14. Idiopathic tracheal stenosis*
Circumferential stenosis
Subglottic
Female predominance
*Courtesy J. Janssen
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15. Tracheal tumors Adenoid cystic carcinoma Squamous cell carcinoma
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16. Malignant central airway obstruction
Invading Thyroid cancer with extrinsic compression
Necrotic Intrluminal, exophytic Squamous cell cancer obstructing Right main bronchus
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17. Intraluminal exophytic lesions
Necrotic Squamous cell Nodular Adenocarcinoma Nodular Squamous cell
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18. Extrinsic compression
Compression Left Main Bronchus from Esophageal cancer
Compression trachea (with invasion) from Adenoid Cystic Carcinoma
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19. Carina adenopathy Subcarina and posterior carina adenopathy
Subcarina and Pretracheal adenopathy
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20. Neoplasm of carina
Adenocarcinoma obstructing left and right main bronchi and lower third of trachea above the carina.
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21. Extrinsic compression from esophageal cancer and esophageal stent
Compression Left Main Bronchus
Silicone stent for palliation
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22. Miscellaneous airway findings
Tracheo-esophgeal fistula Foreign body Tracheal bronchus
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23. Repaired tracheocele with pus-filled pouch causing recurrent pneumonia
Inside pouch
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24. False track (tracheo-mediastinal fistula caused by tracheotomy tube
Trachea
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25. Granulation tissue growing through fenestration of tracheotomy tube
Patient complains of cough, difficulty speaking, and occasional hemoptysis
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26. BRONCHATLAS©
Step by Step©
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This presentation is part of a multidimensional competency-oriented curriculum for Flexible Bronchoscopy.
Our goal is to eliminate patient suffering caused by unequal physician expertise and on-the-job training.
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Bronchoscopy International: BronchAtlas©, an Electronic On-Line Multimedia Slide Presentation. Published (Please add “Date Accessed”).
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