Tuberculous broncholithiasis

Case contributed by Melbourne Uni Radiology Masters


Previous history of left upper lobe resection of aspergilloma. Nature of lesions in the right lung?

Patient Data

Age: 55 years
Gender: Male

Chest radiograph

Evidence of the previous thoracoplasty with left upper lobe resection.

Ovoid densities in the right middle lobe with a finger-in-glove type appearance suspicious for mucus plugging of dilated bronchi, a finding of allergic bronchopulmonary aspergillosis.

The remainder of the lungs is clear.

No pleural effusion.


CT Chest

Non contrast scans were performed through the chest.

Direct comparison is made to previous CT chest performed. Left upper lobectomy noted.

Bronchiectasis and bronchiolectasis of the right middle lobe, anterior basal segment of the right lower lobe and apical segment of the left lower lobe.

The previously described 1.2 cm subpleural nodule in the left lower lobe apical segment has morphology that is more consistent with scarring when reviewed on multiplanar reformats.

Multiple calcified granulomas within the right lung and areas of minor subpleural scarring.

Some architectural distortion of the left lower lobe anteriorly.

Calcified mediastinal lymph nodes consistent with previous granulomatous disease.


Overall appearances in the left lower lobe apical segment is most likely secondary to scarring from previous infection.

Case Discussion

This patient had a past history of pulmonary TB, later complicated by aspergilloma formation in the left upper lobe.

Recurrent hemoptysis lead to a left upper lobectomy.

The calcified lesions in the right lung are old tuberculous broncholiths (broncholithiasis)

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Case information

rID: 38466
Published: 23rd Jul 2015
Last edited: 14th Aug 2019
System: Chest
Tag: rmh
Inclusion in quiz mode: Included

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