Signs and Symptoms of Chest Diseases: Fellow Case Report Poster - Signs and Symptoms of Chest Disease |

Broncholithiasis: An Uncommon Cause of Hemoptysis FREE TO VIEW

Prangthip Charoenpong, MD; Khushboo Chokshi, MD; Rosa Arancibia, MD; George Apergis, MD
Author and Funding Information

SUNY Downstate Medical Center, Brooklyn, NY

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

Chest. 2016;150(4_S):1247A. doi:10.1016/j.chest.2016.08.1360
Text Size: A A A
Published online

SESSION TITLE: Fellow Case Report Poster - Signs and Symptoms of Chest Disease

SESSION TYPE: Affiliate Case Report Poster

PRESENTED ON: Tuesday, October 25, 2016 at 01:30 PM - 02:30 PM

INTRODUCTION: Broncholithiasis is caused by a calcified lymph node eroding bronchial wall and an opening into the bronchial lumen. Granulomatous lymphadenitis caused by TB infections is the most common cause worldwide. Patients may present with cough, dyspnea, hemoptysis or asymptomatic. The diagnosis is often overlooked as it is not a common finding and CXR often fails to detect it.

CASE PRESENTATION: 58 year old female with history of DM, old TB (since 17 year old, completed treatment) presented to hospital with hemoptysis for 2 weeks. Patient was here to visit her family from Morocco. She has had hemoptysis with minimal blood for 2 weeks. She had a similar episode 3 years ago but did not seek medical attention. She denied fevers, chills, night sweats or weight loss, no chest pain or shortness of breath. CXR showed mild soft tissue prominence within the right perihilar region and bronchiectasis within the right upper lobe. CT chest showed obstruction of right upper lobe bronchus at the level of the hilum with postobstructive fluid filled bronchiectasis, 6 mm calcified broncholith at the level of the right hilum. She was treated with ceftriaxone and azithromycin. Sputum AFBs were negative. Patient underwent diagnostic bronchoscopy which revealed a large broncholith obstructing bronchus at subsegmental level which was extracted. Patient was doing well after procedure and had no more hemoptysis.

DISCUSSION: Broncholithiasis is an unusual condition with an incidence of only 0.1% to 0.2%(1) of all lung diseases. A broncholith is usually formed by compression and erosion of calcified peribronchial lymph nodes, as a result of respiratory movement and cardiac pulsation, into the lumen of the bronchus(2). Patients can present with wide variety of respiratory symptoms and can have complications include recurrent pneumonia, bronchiectasis, massive hemoptysis, and fistula. Treatment options include observation as spontaneous expectoration may occur or intervention by bronchoscopic removal or surgery particular in symptomatic patient.

CONCLUSIONS: Broncholithiasis should be kept in mind in patients who had hemoptysis and calcified mediastinal lymph nodes. Diagnostic bronchoscopy should be done to confirm diagnosis.

Reference #1: Anwer M, et al. Broncholithiasis: “incidental finding during bronchoscopy”-case report and review of the literature. J Bronchol Intervent Pulmonol.2011;18:181-183.

Reference #2: Ungprasert P, et al. Broncholithiasis: An uncommon cause of chronic cough. J Bronchology Interv Pulmonol. 2014 Jan; 21(1):102-3.

DISCLOSURE: The following authors have nothing to disclose: Prangthip Charoenpong, Khushboo Chokshi, Rosa Arancibia, George Apergis

No Product/Research Disclosure Information




Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543