Tracheal Dystonia and Sarcoidosis

Abstract

A case of tracheal dystonia is submitted. In a 44-year-old woman with increasing dyspnoea of predominantly expiratory type, bronchoscopy revealed abnormal yielding and bulging of the right side of the membranous tracheal wall. The bulging was situated in the upper 8 cm of the trachea and varied in extent with the intratracheal pressure. At operation the membranous wall was found to be extremely yielding, in spite of normal width. Adjacent to the abnormal part of the membranous wall there was an enlarged lymph node which on microscopic examination exhibited changes indicating sarcoidosis. The membranous wall was supported by a strip of Teflon, and since the operation the expiratory dyspnoea has improved. The present case is compared with reported cases of tracheobronchial dystonia. It is concluded that the yielding of the membranous wall may have been due to long-lasting pressure by the lymph node, destroying the submucous elastic fibres.