Current Medical Issues

CME QUIZ
Year
: 2019  |  Volume : 17  |  Issue : 3  |  Page : 94--95

Right lung broncholith


Darpanarayan Hazra, Ajay Christopher, Kundavaram Paul Prabhakar Abhilash 
 Department of Emergency Medicine, CMC, Vellore, Tamil Nadu, India

Correspondence Address:
Dr. Darpanarayan Hazra
Department of Emergency Medicine, CMC, Vellore - 632 004, Tamil Nadu
India




How to cite this article:
Hazra D, Christopher A, Abhilash KP. Right lung broncholith.Curr Med Issues 2019;17:94-95


How to cite this URL:
Hazra D, Christopher A, Abhilash KP. Right lung broncholith. Curr Med Issues [serial online] 2019 [cited 2022 Jul 3 ];17:94-95
Available from: https://www.cmijournal.org/text.asp?2019/17/3/94/267908


Full Text

 Question



A 50-year-old woman presented with complaints of low-grade fever for 1 month and dry cough and intermittent hemoptysis.

Shown here is her chest radiograph, what is your diagnosis?

 Answer



Posteroanterior radiograph shows an irregular calcified nodule in the right middle lobe of the lung (arrow), suggestive of a broncholith. [Figure 1]{Figure 1}

A broncholith is defined as the presence of calcified material within tracheobronchial tree or within a cavity communicating with a bronchus. They originate from calcified peribronchial lymph nodes which subsequently erode the bronchus. They may remain asymptomatic or may produce nonspecific symptoms. It is most frequently caused by histoplasmosis or tuberculosis (TB).[1],[2] Bronchial distortion, irritation, and erosion by broncholiths can cause bronchiectasis, cough, recurrent pneumonias, hemoptysis, and dyspnea. Life-threatening complications, such as massive hemoptysis or bronchoesophageal fistulas, can also occur. Broncholiths may not be diagnosed for a prolonged period because of its varied presentation. Radiographic findings include the presence of a calcified nodule along with the underlying disease processes, namely airway obstruction, mucoid impaction, bronchiectasis, or expiratory air trapping. Other radiographic findings may include the disappearance of a previously identified calcified nidus or change in position of a calcified nidus.[1],[2]

Broncholiths are often detected during evaluating symptoms of complications, e.g., hemoptysis and recurrent chest infection. Broncholiths should be removed preferably through a rigid bronchoscope.[2],[3]

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Potaris K, Miller DL, Trastek VF, Deschamps C, Allen MS, Pairolero PC, et al. Role of surgical resection in broncholithiasis. Ann Thorac Surg 2000;70:248-51.
2Cerfolio RJ, Bryant AS, Maniscalco L. Rigid bronchoscopy and surgical resection for broncholithiasis and calcified mediastinal lymph nodes. J Thorac Cardiovasc Surg 2008;136:186-90.
3Conces DJ Jr., Tarver RD, Vix VA. Broncholithiasis: CT features in 15 patients. AJR Am J Roentgenol 1991;157:249-53.