Broncholithiasis

Last revised by Yuranga Weerakkody on 20 Jan 2022

Broncholithiasis (singular broncholith) is a term given for the presence of calcified or ossified material within the lumen of the bronchus.

  • dry cough
  • hemoptysis
  • fever, chest pain, rigors: due to obstructive pneumonia
  • lithoptysis: coughing up of broncholith(s)
    • rarely

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 / mucoid impaction.

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

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Cases and figures

  • Case 1: tuberculous broncholithiasis
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