Y. Kano et al., HISTOPATHOLOGICAL AND IMMUNOHISTOCHEMICAL STUDIES OF ACQUIRED TRACHEOBRONCHOMALACIA - AN AUTOPSY CASE-REPORT, ORL, 58(5), 1996, pp. 288-294
A 72-year-old patient was reported to have 'saber-sheath-type' acquire
d tracheobronchomalacia after irradiation therapy for laryngeal cancer
. The pathogenetic features of this case were demonstrated immunohisto
pathologically using CD68, HLA-DR, UCHL1, L26 and Ki-67 antibodies. Th
e principal features were (a) selective destruction of the cartilage w
ith Ki-67 stainability from the trachea to the segmental bronchi with
inflammatory infiltrations of predominant T lymphocytes (UCHL1-positiv
e) and activated macrophages (CD68-positive with marked HLA class II a
ntigen) and (b) replacement by collagen fibers through the affected le
sion. The tissues, except for the cartilage in the airway tract, were
preserved without marked change, including the membranous portion. The
cartilage at organs other than the airway showed no changes. We first
clarified the immunohistopathology of tracheobronchomalacia. We propo
sed that the characteristic cell-mediated immunity against cartilage w
ith T lymphocytes and activated macrophages in the pathogenetic featur
es may be related to a cancer-healing tendency.