Anomalies in the development of the tracheobronchial tree (clinical case)

• Published in: Sibirskiĭ nauchnyĭ medit︠s︡inskiĭ zhurnal Vol. 43; no. 4; pp. 154 - 159
• Main Authors: Semichev, E. V., Medvedeva, N. N.
• Format: Journal Article
• Language: English; Russian
• Published: Russian Academy of Sciences, Siberian Branch Publishing House 31-08-2023
• Subjects: anomalies of branching of the bronchi; anomaly of the development of the tracheobronchial tree; defects of the bronchopulmonary system; tracheal bronchus; “high” right upper lobe bronchus
• ISSN: 2410-2512; 2410-2520
• DOI: 10.18699/SSMJ20230417

According to the International Classification of Diseases the trachebronchial tree (TBT) anomalies are grouped into class XVII “Congenital anomalies (malformations), deformities and chromosomal disorders” (Q30–Q34, namely Q32.1 – “Other malformations of the trachea”).This paper presents a clinical case of congenital anomaly of TBT. Patient M., 18 years old, diagnosis of ICD-10 J90 Pleural effusion, not classified elsewhere, was referred from the pulmonology department to perform bronchoscopy for differential diagnosis with pulmonary tuberculosis. When the device was passed through the trachea, in the lower third towards the right main bronchus, a diverticuloid protrusion of the tracheal wall with deformation of the cartilaginous ring was found.
Results and discussions
. After examination, the conclusion was formed: Anomaly in the development of the lower third of the trachea (reduced tracheal bronchus on the right). Anomalies in the development of TBT are an extremely rare pathology, the pathology we describe is called “tracheal bronchus”. The tracheal bronchus, the rarest malformation of TBT with a frequency of no more than 1–2 % of cases, is the result of dysontogenesis. It is usually located on the right side of the trachea and may end blindly in the form of a diverticulum. In our description, there is no other anomaly of the TBT, so it can be attributed to the supernumerary variant of the tracheal bronchus. When anomalies in the development of TBT are detected, it is necessary to carry out differential diagnostics with tracheal diverticula, in which only its membranous part suffers.
Conclusions
. The clinical case we are describing refers to a supernumerary variant of the tracheal bronchus and requires the additional use of high-tech verification methods. We do not exclude that the environmental factors in the city of Zheleznogorsk could be the cause of its development.