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Relapsing Polychondritis Affecting the Lower Respiratory Tract

Jeffrey V. Behar1, Yo-Won Choi2, Thomas A. Hartman3, Nancy B. Allen4 and H. Page McAdams1

1 Department of Radiology, Duke University Medical Center, Box 3808, Durham, NC 27710.
2 Department of Radiology, Hanyang University Hospital, 17 Haengdang-dong, Sungdong-Ku, Seoul 1333-792, Korea.
3 Department of Radiology, Mayo Medical Institutions, 200 First St. S.E., Rochester, MN 55905.
4 Department of Medicine, Duke University Medical Center, Durham, NC 27710.



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  		Fig. 1. —Relapsing polychondritis in 54-year-old man with dyspnea. CT scan (soft-tissue window, 6-mm collimation) shows smooth thickening and subtle increased attenuation of tracheal wall. Note that posterior membranous portion of trachea (arrow) is not affected.

 


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  		Fig. 2. —45-year-old asymptomatic man. CT scan (soft-tissue window, 2.5-mm collimation) of patient without relapsing polychondritis shows appearance of normal trachea for comparison. Note smooth, almost imperceptible wall.

 


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  		Fig. 3A. —Relapsing polychondritis in 47-year-old man with dyspnea. CT scans (soft-tissue window, 5-mm collimation) show marked thickening and increased attenuation of tracheal (A) and bronchial (B) walls with focal calcification (arrowheads). Note that posterior membranous portion of airway walls (arrows) are not affected.

 


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  		Fig. 3B. —Relapsing polychondritis in 47-year-old man with dyspnea. CT scans (soft-tissue window, 5-mm collimation) show marked thickening and increased attenuation of tracheal (A) and bronchial (B) walls with focal calcification (arrowheads). Note that posterior membranous portion of airway walls (arrows) are not affected.

 


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  		Fig. 4. —35-year-old asymptomatic woman.

CT scan (soft-tissue window, 2.5-mm collimation) of patient without relapsing polychondritis shows appearance of normal main bronchi for comparison. Note smooth, almost imperceptible walls.

 


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  		Fig. 5. —Relapsing polychondritis in 66-year-old man with dyspnea. CT scan (soft-tissue window, 6-mm collimation) shows nodular thickening and calcification of distal trachea.

 


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  		Fig. 6A. —Relapsing polychondritis in 50-year-old woman. CT scan (soft-tissue window, 5-mm collimation) obtained at thoracic inlet shows normal-caliber trachea.

 


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  		Fig. 6B. —Relapsing polychondritis in 50-year-old woman. CT scan (soft-tissue window, 5-mm collimation) obtained at more caudal level shows mild focal stenosis of intrathoracic trachea.

 


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  		Fig. 7A. —Relapsing polychondritis in 48-year-old woman with dyspnea and pneumonia. (Reprinted with permission from [11]) Inspiratory CT scan (lung window, 10-mm collimation) shows thickened anterior cartilaginous portion of bronchi (arrows) and normal lung parenchyma. Note narrowing of both main bronchi.

 


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  		Fig. 7B. —Relapsing polychondritis in 48-year-old woman with dyspnea and pneumonia. (Reprinted with permission from [11]) Expiratory CT scan (lung window, 10-mm collimation) shows complete collapse of left main bronchus and air trapping in left lung.

 

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