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A 41-year-old woman presented with a long-standing history of recurrent cough and chest tightness. She had previously been diagnosed with tracheobronchial amyloidosis based on bronchoscopic biopsy findings and had received symptomatic treatment. In 2024, the patient experienced a marked exacerbation of chest tightness and presented to our hospital. Axial CT revealed irregular thickening of the tracheal wall with luminal narrowing (figure 1A and B), while coronal and sagittal reconstructions further delineated the length and severity of segmental stenosis (figure 1C and D). Bronchoscopic examination identified marked subglottic narrowing approximately 2 cm below the vocal cords, with smooth mucosal protrusions distorting the airway lumen (figure 1E). Histopathological evaluation confirmed extensive subepithelial amyloid deposition accompanied by mild epithelial dysplasia, consistent with tracheobronchial amyloidosis (figure 1F).