Diffuse Lung Disease: Diffuse Lung Disease |

A Case Report of Broncholithiasis FREE TO VIEW

Jin Ren, PhD; Tiangang Ma, PhD; Jinzhi Yin, BS; Rong Gao, PhD
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The Second Hospital, Jilin University, Changchun, China

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;149(4_S):A200. doi:10.1016/j.chest.2016.02.207
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SESSION TITLE: Diffuse Lung Disease

SESSION TYPE: Case Report Poster

PRESENTED ON: Sunday, April 17, 2016 at 11:45 AM - 12:45 PM

INTRODUCTION: Broncholithiasis is a rare condition on clinic. It refers to the condition that the component of calcification or ossification appear in the lumen of bronchus. The patient with broncholithiasis may have no symptoms and also can have series of symptoms including cough, dyspnea, chest pain or hemoptysis. Because it is a rare condition, many doctors may ignore it and make a wrong diagnosis.

CASE PRESENTATION: A 46 years old female patient, complained of chest pain, cough and sputum for three months. She felt right chest pain three months ago, the pain was persisting. She had coughing and large amount of white sputum. Two months ago she was diagnosed with pneumonia and treated with amoxicillin for 1 week but the symptoms were not relieved. One months ago, she coughed up some whtie material like stone. The shape of the stone is irregular, the diameter is about 5mm. Five days ago she had severe cough and yellow sputum and then came to our hospital. PE: The chest wall was symmetrical, percussion note was resonance, the breath sound was normal and no rales in alscultation. Blood rountine test: WBC 9.6×109/L, percentage of eosinophil was 10.8%. Blood coagulation is normal. Serum tests including hepatic function and renal function were normal. Chest CT scanning showed the infiltration in the right middle lobe, and calcification near the right middle bronchial, and the calcificated lymph node in the mediastinum. The results under the fibre bronchoscope showed the ulceration in the right middle bronchial. The results of acid-fast bacilliin sputum and BALF sample were negative. After the treatment of antibiotics, the patient was recovered.

DISCUSSION: The probability of broncholithiasis in respiratory diseases account for 0.1%-0.2%. Broncholithiasis is more seen in the right bronchial than in the left, and this is related to the anatomy of the bronchials, the right bronchial is easier to be affected by the calcificated lymph node. In China, the most common reason for broncholithiasis is pulmonary tuberculosis. The most common symptom of this condition is dry cough. Some patients may have fever, chest pain and hemoptysis. Chest CT scan is better in the diagnosis than X-ray. The treatment include observation, moving the stone through fibre bronchoscope and surgery.

CONCLUSIONS: Although broncholithiasis is rare, when the patients have hemoptysis and dyspnea especially with the history of pulmonary tuberculosis and calcificated lymph node, broncholithiasis should be taken into account.

Reference #1: Patompong U, Narat S, Michael A. B, Lee C. E. Broncholithiasis: An Uncomm on Cause of Chronic Cough. J. Bronchol Intervent Pulmonol.2014:21:1.

Reference #2: Anwer M, Venkatram S. Broncholithiasis: “incidental finding during bronchoscopy”—case report and review of the literature. J Bronchol Intervent Pulmonol. 2011;18:181-183.

Reference #3: Mayuri A Kamble, Anand P Thawait, Ashok T Kamble. Rare presentation of bronchiectasis with multiple bronchial stones. Scottish Medical Journal.2015, Vol. 6 0 (1) e14-e18.

DISCLOSURE: The following authors have nothing to disclose: Jin Ren, Tiangang Ma, Jinzhi Yin, Rong Gao

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