Source: Annual Congress 2011 - The new clinical spectrum of lung diseases: from bronchi to pleura
Disease area: Respiratory infections

Abstract

Broncholithiasis is defined as the presence of a calcified fragment of tissue within a bronchus. It almost invariably represents the end-stage of healing of granulomatous diseases such as histoplasmosis or tuberculosis. Broncholiths are found with almost equal frequency in men and women, mostly in the fifth or sixth decade. Common symptoms are chronic cough, hemoptysis and sputum. Lithoptysis, which is pathognomic, is rare. The chest radiograph mostly shows calcified masses around the bronchi. In most cases, because of no significant symptoms or complications, observation may be the best course but bronchoscopic removal or surgical interventions are indicated in some instances.
From June 1996 to December 2010, 24 patients with broncholithiasis had undergone the analysis for clinical manifestation, bronchoscopic finding, treatment modality and follow-up status.
Broncholithiasis was developed in association with tuberculosis in 45.8% and locations corresponded in 54.5%. Lithoptysis occurred in 20.8%. Obstructive pneumonitis was the most common radiographic finding, and calcification was found in 50.0%. Various positive findings, noted in all patients undergoing flexible bronchoscopy, included visible broncholith, granulation tissue or blood clots. In follow-up patients, while all patients with conservative care only continued to have symptoms, an excellent result was evident in 8 of 11 patients in whom broncholith was removed after treatment or spontaneously.
A clinical awareness of the manifestations of broncholithiasis will result in early diagnosis and treatment. If the broncholith can be removed, as indicated, before irreversible distal bronchial and parenchymal damages occur, the long-term outlook for symptomatic relief is excellent.

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Citations should be made in the following way:
H. L. Lee, H. S. Nam, J. H. Cho, J. S. Ryu (Incheon, Republic Of Korea). A clinical study on broncholithiasis. Eur Respir J 2011; 38: Suppl. 55, 499

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