Broncholithiasis is a term given for the presence of calcified or ossified material within the lumen of the bronchus.
A broncholith is usually formed by erosion by and extrusion of a calcified adjacent lymph node into the bronchial lumen and is usually associated with long-standing foci of necrotizing granulomatous lymphadenitis. Other causes of broncholithiasis include
- aspiration of bone tissue or in situ calcification of aspirated foreign material
- erosion by and extrusion of calcified or ossified bronchial cartilage plates
- migration to a bronchus of calcified material from a distant site, e.g. pleural plaque or the from the kidney (nephrobronchial fistula)
Calcified opacity within a bronchus.
There may be associated distal lung collapse or airway dilatation.
Treatment and prognosis
In some cases they may be left alone while in other cases, they can be removed safely by rigid bronchoscopy with the aid of Nd-YAG laser photocoagulation 9.
Imaging differential considerations include 4
- 1. Seo JB, Song KS, Lee JS et-al. Broncholithiasis: review of the causes with radiologic-pathologic correlation. Radiographics. 2002;22 Spec No (suppl 1): S199-213. Radiographics (full text) - Pubmed citation
- 2. Conces DJ, Tarver RD, Vix VA. Broncholithiasis: CT features in 15 patients. AJR Am J Roentgenol. 1991;157 (2): 249-53. doi:10.2214/ajr.157.2.1853800 - Pubmed citation
- 3. Shin MS, Ho KJ. Broncholithiasis: its detection by computed tomography in patients with recurrent hemoptysis of unknown etiology. J Comput Tomogr. 1983;7 (2): 189-93. Pubmed citation
- 4. Eurorad teaching files : Case 11427
- 5. Arrigoni MG, Bernatz PE, Donoghue FE. Broncholithiasis. J. Thorac. Cardiovasc. Surg. 1971;62 (2): 231-7. Pubmed citation
- 6. Ferretti G, Coulomb M, Blanc-Jouvan F et-al. Diagnosis of broncholithiasis. Role of high resolution tomodensitometry. J Radiol. 1995;75 (10): 531-6. Pubmed citation
- 7. Menivale F, Deslee G, Vallerand H et-al. Therapeutic management of broncholithiasis. Ann. Thorac. Surg. 2005;79 (5): 1774-6. doi:10.1016/j.athoracsur.2003.10.124 - Pubmed citation
- 8. Ryberg AA, Gengler JS, Angelillo VA et-al. Broncholithiasis: case report and literature review. Nebr Med J. 1996;81 (1): 14-7. Pubmed citation
- 9. Nollet AS, Vansteenkiste JF, Demedts MG. Broncholithiasis: rare but still present. Respir Med. 1999;92 (7): 963-5. Pubmed citation
- 10. Theriault M, Eddy K, Borgaonkar J, Babar J, Manos D. Diseases Involving the Central Bronchi: Multidetector CT for Detection, Characterization, and Differential Diagnosis. Radiographics: a review publication of the Radiological Society of North America, Inc. 38 (1) 2018