Broncholith

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

Clinical presentation

  • dry cough
  • hemoptysis
  • fever, chest pain, rigors: due to obstructive pneumonia

and rarely:

  • lithoptysis: coughing up of broncholith(s)

Pathology

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)

Radiographic features

CT

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 .

Differential diagnosis

Imaging differential considerations include