We herein present three cases of broncholithiasis experienced in the past 11 years in Chang Gung Memorial Hospital. The presenting manifestations are obstructive pneumonia in two cases, and hemoptysis in the other one. [ncbi.nlm.nih.gov]

• Cervical Lymphadenopathy

  No clubbing or cervical lymphadenopathy was detected but JVP was raised. Respiratory system examination showed laboured breathing with bilateral inspiratory crackles and rhonchi. Abdominal examination showed tender hepatomegaly with ascitis. [ncbi.nlm.nih.gov]

• Sulfur Granules

  The nodules included sulfur granules containing Gram-positive branching filamentous organisms consistent with Actinomyces. [rc.rcjournal.com]

  (c) Photomicrograph (original magnification, 400; H-E stain) shows sulfur granules surrounded by eosinophilic “clubbing” materials (arrows); this finding is typical for actinomycosis. (Reprinted, with permission, from reference ,21.) Figure 10b. [pubs.rsna.org]

• Soft Tissue Mass

  An associated soft-tissue mass was not seen in any case. Difficulty in determining the relationship between lymph node and bronchus is due to volume averaging, which can be decreased by scanning thinner sections. [ncbi.nlm.nih.gov]

  tissue mass Atelectasis is the most common parenchymal finding Mucoid impaction Post-obstructive infection may result Bronchiectasis Expiratory air-trapping is uncommon Differential Diagnosis Carcinoid tumor Calcification in a fungus ball Hamartomas [learningradiology.com]

  Chest x-ray revealed atelectasis in the right upper lobe (RUL) (Fig. 1A) and subsequent computed tomography of chest demonstrated a small soft-tissue mass with peripheral high-density foci in the RUL bronchus (Fig. 1B). [journals.lww.com]

• Painter

  During his subsequent jobs as a painter and doorman, there was no exposure to silica dust. Physical examination disclosed diminished breath sounds and sparse ronchi, as well as finger clubbing. [erj.ersjournals.com]

• Malnutrition

  Support System The patient’s age and diabetes mellitus status put her at risk for what is known as geriatric syndrome, which comprises functional disabilities, depression, falls, urinary incontinence, malnutrition, and cognitive impairment. [clinicalgate.com]

• Cough

  A case is reported of broncholithiasis in a 29-year-old female factory worker presenting with cough and lithoptysis. [ncbi.nlm.nih.gov]

  Case: A 60-yr. female non-smoker presented with abrupt onset, episodic, severe cough precipitated by drinking fluids. Ingestion of liquids resulted in immediate cough and expectoration of swallowed liquid. [nature.com]

• Dry Cough

  Broncholithiasis 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 and rarely: lithoptysis: coughing up of broncholith(s) A [radiopaedia.org]

  The main symptom is a dry cough with eventual expectoration. Haemoptysis may vary from mild to severe. Fever and chills are often related to infectious complications. Wheezing may occasionally occur due to mechanical obstruction of the airways. [erj.ersjournals.com]

  She had a dry cough and chest pain for 2 months before this episode. [academic.oup.com]

• Abnormal Breathing

  On evaluation after the hemoptysis, she had no tachypnea, abnormal breath sounds to auscultation, or other abnormal findings on physical examination. Growth and development were normal for age. [academic.oup.com]

• Pursed-Lip Breathing

  lip breathing, rhonchi, wheezing, tympani to percussion, distant heart sounds Acute exacerbation of chronic bronchitis, primary lung cancer, pneumonia Gingival thickening, mulberry gingivitis, saddle nose, nasal septum perforation Wegener’s granulomatosis [aafp.org]

• Chest Wall Pain

  Other patients have had chest wall pain, 2, 13 but our patient did not. [rc.rcjournal.com]

• Loss of Appetite

  CASE SUMMARY A 47 year old female was admitted with complaints of increased breathlessness, generalized swelling of the body and loss of appetite for the past one month. [ncbi.nlm.nih.gov]

[…] on a compatible clinical history of chronic respiratory symptoms, such as a daily cough and viscid sputum production (see Clinical), and characteristic radiographic findings on CT scans, such as bronchial wall thickening and luminal dilatation (see Workup [emedicine.medscape.com]

• Pulmonary Infiltrate

  Generally, ABPA is clinically characterized by poorly controlled asthma, recurrent pulmonary infiltration, and bronchiectasis. [e-sciencecentral.org]

  Pulmonary infiltrates, when coupled with eosinophilia in an asthmatic subject, have raised an initial suspicion of some kind of eosinophilic lung disease such as ABPA, chronic eosinophilic pneumonia, or Churg-Strauss syndrome ( 7 ). [synapse.koreamed.org]

  infiltrates, and central bronchiectasis. [ijccm.org]

• Coccidioides Immitis

  CF and ID assays were negative for Blastomyces dermatitidis, Coccidioides immitis, and Aspergillus fumigatus. Figure 1. First bronchoscopy with broncholith. Figure 1. First bronchoscopy with broncholith. [academic.oup.com]

  It is usually associated with long-standing foci of necrotizing granulomatous lymphadenitis; any organism leading to such inflammation, including Mycobacterium tuberculosis (,,,,,Figs 1, ,,,6, ,,,,7), Histoplasma capsulatum, Coccidioides immitis, and [pubs.rsna.org]

• Mycobacterium Kansasii

  Here we describe a 14-year-old boy known to have disseminated Mycobacterium kansasii (M. kansasii) infection associated with hypoplastic myelodysplastic syndrome (MDS). He was presented with cough and fever. [ncbi.nlm.nih.gov]

  Arch Path, 1971, vol. 91 (pg. 577 - 9 ) 6 Broncholithiasis in an immune compromised boy with disseminated Mycobacterium kansasii, Pediatr Pulmonol, 2007, vol. 42 (pg. 980 - 3 ) 7 Early adolescent primary ciliary dyskinesia associated with broncholithiasis [academic.oup.com]

• Complement Fixing Antibody

  She was seronegative for complement fixing antibody to the mycelial antigen. H and M bands were not detected in immunodiffusion (ID) assay. CF and ID assays were negative for Blastomyces dermatitidis, Coccidioides immitis, and Aspergillus fumigatus. [academic.oup.com]

• Chlamydia

  Tests for chlamydia and cytomegalo*From the Department of Cardiolotw, Thorucentre, University Hospital Groningen, Groni!lgen, the""Netherlands. Reprint : Dr. oan tlir Unde, DeJJartment of Cardlolotz.rJ, . [kundoc.com]

• Amyloid Plaque

  It shows localized or diffuse involvement of the tracheobronchial tree with submucosal deposition of amyloid plaques or nodules. [pubs.rsna.org]

The aim of this study was to evaluate the imaging diagnosis and surgical treatment of broncholithiasis. [ncbi.nlm.nih.gov]

Treatment involved retrieval of the obstructing stone, debridement and drainage of the pleuroperitoneal phlegmon/abscess, and intravenous antibiotics. The case illustrates the need to remove gallstones at the time of cholecystectomy. [scholars.northwestern.edu]

The prognosis of these patients is generally excellent; however, a significant number require surgery because of persistent symptoms or a complication of the disease. [ncbi.nlm.nih.gov]

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. [radiopaedia.org]

The prognosis of broncholithiasis is usually favourable and its treatment is restricted to clinical follow-up. Some invasive procedures may be necessary, depending on location, size and associated complications. [erj.ersjournals.com]

The finding of Actinomyces throughout the broncholith is strong evidence that the etiology of the broncholithiasis was a primary pulmonary Actinomyces infection. [ncbi.nlm.nih.gov]

Etiology Histoplasmosis (see [[Histoplasmosis]]) Most common cause in US Usually calcified node eroding into airway Tuberculosis (see [[Tuberculosis]]) Usually calcified node eroding into airway Coccidioidomycosis (see [[Coccidioidomycosis]]) Usually [mdnxs.com]

Chapter 8 Pulmonary Infectious Complications of Tumor Necrosis Factor Blockade 681 Chapter 9 The Convergence of the Global Smoking COPD Tuberculosis HIV and Respiratory Infection Epidemics 693 Epidemiology and Management Challenges 705 An Emerging and [books.google.com]

Epidemiology Currently no systematic data are available on the incidence or prevalence of bronchiectasis. [emedicine.medscape.com]

Causes Pulmonary Tuberculosis Histoplasmosis Silicosis Pathophysiology Broncholith perforates Calcified lymph node or granuloma Perforation extends from hilar region into Bronchi Symptoms Sudden onset cough Hemoptysis (may be massive) Signs Hemoptysis [fpnotebook.com]

Staging of Alberto de Hoyos 2177 Less Common Malignant Tumors of the Diagnostic Investigation of Mediastinal 2195 The Use of Prosthetic Grafts to Replace 195 Poorly Differentiated Carcinoma of the Mediastinum 2411 2261 Benign and Malignant Neurogenic 2415 Pathophysiology [books.google.de]

The pathophysiology of this condition is still unknown, but we think that it is related to prolong tracheostomy. We recommend performing chest radiography in all cases of tracheostomy obstruction. [ejo.eg.net]

Clinical, pathophysiologic, and microbiologic characterization of bronchiectasis in an aging cohort. Chest. 1995 Oct. 108(4):955-61. [Medline]. Seitz AE, Olivier KN, Steiner CA, et al. [emedicine.medscape.com]

Early diagnosis and treatment will prevent the severe complications that can occur from continued observation. [ncbi.nlm.nih.gov]

[…] force to remove • 80% require surgery: Bronchotomy and stone extraction or segmentectomy/ lobectomy • Unable to remove via bronchoscopy (80% of cases) • Tracheoesophageal fistulas: Repair with intercostals muscle flap between airway and esophagus to prevent [accesssurgery.mhmedical.com]

Guidelines for the management of adults with community-acquired pneumonia: diagnosis, assessment of severity, antimicrobial therapy, and prevention. Am J Respir Crit Care Med 2001;163:1730-54. ‎ [books.google.de]

Tissue interposition during surgical closure prevents recurrence. [nature.com]

To prevent serious complications such as massive haemoptysis and fistula with the oesophagus or mediastinum, immediate treatment is essential. [thorax.bmj.com]