Objective: To point out to tracheobronchomegaly as a differential diagnosis in children with chronic respiratory disorders. Methods: The patient's data were obtained from his chart review and bibliographical data were obtained from the Medline System. Results: This is a case report on a 15-year-old, white, male patient who had been followed up in the Pulmonology Unit of the Children's Institute since he was 10 years old. His history included wheezing episodes and recurrent respiratory tract infections since he was 5 months old. The initial diagnosis was asthma, but, since the patient responded only partially to treatment, a chest computerized tomography was performed. It revealed an enlargement of the tracheal and right bronchial dimensions, confirming the diagnosis of tracheobronchomegaly. Conclusions: Tracheobronchomegaly is a rare disease in children. This entity should be thought in children with chronic respiratory diseases of unidentified etiology. To date, no definitive treatment is available.

Keywords: Tracheobronchomegaly. Obstructive lung diseases.

Mounier-Kuhn syndrome, or tracheobronchomegaly, is a rare clinical entity characterized by abnormal dilation of the trachea and main bronchi. The diagnosis can usually be made by measuring the tracheal diameter. We report the case of a 40-year-old black man with refractory lower respiratory tract infection. Tracheobronchomegaly was confirmed through computed tomography.

Keywords: Tracheobronchomegaly/diagnosis; Tomography, X-ray computed; Tracheobronchomegaly/rehabilitation;

The aim of this pictorial essay was to present the main computed tomography findings seen in diffuse diseases of the trachea. The diseases studied included amyloidosis, tracheobronchopathia osteochondroplastica, tracheobronchomegaly, laryngotracheobronchial papillomatosis, lymphoma, neurofibromatosis, relapsing polychondritis, Wegener's granulomatosis, tuberculosis, paracoccidioidomycosis, and tracheobronchomalacia. The most common computed tomography finding was thickening of the walls of the trachea, with or without nodules, parietal calcifications, or involvement of the posterior wall. Although computed tomography allows the detection and characterization of diseases of the central airways, and the correlation with clinical data reduces the diagnostic possibilities, bronchoscopy with biopsy remains the most useful procedure for the diagnosis of diffuse lesions of the trachea.

Keywords: Thoracic diseases; Tracheal diseases; Tomography, X-ray computed; Trachea.

Objective: To investigate the effects of maternal protein malnutrition during lactation on the elastic fibers in the tracheas of Wistar rat pups. Methods: At delivery, 12 male pups of two Wistar rat dams were equally divided into two groups: control, in which the dam received water and standard rat chow ad libitum during lactation; and protein-restricted (PR), in which the dam received water ad libitum and an isoenergetic PR diet (8% protein). At 21 days of age, the pups were killed and their tracheas were excised. The elastic fibers were stained with Weigert's resorcin-fuchsin (after oxidation) and evaluated under light microscopy. Morphometric determinations were performed by stereology, with the point-counting method, and expressed as volumetric densities. Results: Elastic fibers, most having a longitudinal distribution, were identified beneath the tracheal mucosa. In addition, well-defined circular layers of elastic fibers were found around the inner and outer surfaces of the cartilaginous ring. There were no differences between the groups regarding the organization and distribution of the elastic fibers. The volumetric density of the elastic fibers of the pups in the control and PR groups was 2.46 ± 0.99% and 3.25 ± 1.13%, respectively (p < 0.01). Conclusions: The volumetric density of elastic fibers appears to be greater in rat pups breastfed by dams receiving a PR diet than in those breastfed by dams receiving a normal diet.

Keywords: Trachea/growth and development; Trachea/anatomy and histology; Extracellular matrix; Airway remodeling; Malnutrition.