CTICasesFixed Upper Airway Obstruction from Intrathoracic Goiter
Imaging findings
Chest CT demonstrates a massive, heterogeneous, multinodular intrathoracic goiter causing significant extrinsic compression and narrowing of the trachea. Pulmonary function tests demonstrate a classic flow-volume loop with plateauing of both the inspiratory and expiratory curves.
Key takeaways
Large intrathoracic goiters can cause severe, chronic upper airway obstruction. In such cases, PFTs show a characteristic fixed upper airway obstruction pattern, characterized by flattened inspiratory and expiratory flow-volume loops. Radiologists and pulmonologists must correlate imaging findings of tracheal narrowing with these spirometric patterns to avoid misdiagnosing patients with asthma or COPD.
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