A 61-year-old man, admitted due to an 8-month productive cough with hemoptysis, accompanied by low-grade fever, night sweating, diarrhea, and weight loss. He had a close family member who died from multidrug-resistant TB, and no prior personal history. Physical examination was unremarkable, except for a right supraclavicular nodule. Laboratory studies showed positive HIV and Mantoux tests. Chest CT was performed showing right paratracheal and bilateral pulmonary hiliar adenomegalies, along with thickening of the anterolateral tracheal walls (Figure 6A and B). Bronchoscopy showed diffuse submucosal nodules located on the proximal trachea, down to the main bronchi and the anterolateral walls, without affection of the membranous tracheal wall. Tracheal mucosa was normal (Figure 6C and D). Biopsies were performed and TO was confirmed (Figure 7).