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Broncholithiasis


Presentation

  • 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]
  • Eight presented with intractable cough typically worse after drinking that was relieved by lying on either side; 1 patient presented with dysphagia. Six patients reported lithoptysis, and most had a history of recurrent pneumonia.[ncbi.nlm.nih.gov]
  • Cough, hemoptysis, and obstructive pneumonia were the most common presentations. Lithoptysis occurred in only 3 patients.[ncbi.nlm.nih.gov]
  • Broncholithiasis is an uncommon pulmonary problem that may present with life-threatening complications. We report one case of broncholithiasis. A 49-year-old female presented with hemoptysis.[ncbi.nlm.nih.gov]
  • We present two cases of broncholithiasis treated by surgery. Case 1 involves a 57-year-old woman who presented with cough and bloody sputum. She had suffered from recurrent pneumonia in the left lower lobe caused by broncholithiasis for 2 years.[ncbi.nlm.nih.gov]
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]
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]
Pathologist
  • The spleen was also found to contain multiple small calci6c *From Long Island Jewish Medical Center, New Hyde Park, and State University of New York, Stony Brook. tStalf Pathologist, Department of Pathology. :![kundoc.com]
Cough
  • OBJECTIVE: To describe the clinical presentation, diagnostic evaluation, and treatment of bronchoesophageal (BE) fistula due to broncholithiasis, a rare cause of chronic cough with specific therapeutic implications.[ncbi.nlm.nih.gov]
  • Abstract Broncholithiasis, associated most frequently with tuberculosis and histoplasmosis, usually presents with acute onset of cough and hemoptysis. Visible stones are coughed up in fewer cases than was previously believed.[ncbi.nlm.nih.gov]
  • A case is reported of broncholithiasis in a 29-year-old female factory worker presenting with cough and lithoptysis.[ncbi.nlm.nih.gov]
  • Symptoms of broncholithiasis include cough, recurrent episodes of fever, haemoptysis, and purulent sputum. The most common cause of broncholithiasis is Mycobacterium tuberculosis (M. tuberculosis).[ncbi.nlm.nih.gov]
  • An 81-year-old female presented with cough and intermittent wheezing associated with one episode of haemoptysis. Chest radiograph and CT thorax were suggestive of broncholithiasis. This was confirmed by flexible bronchoscopy.[ncbi.nlm.nih.gov]
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]
Chest Wall Pain
  • Other patients have had chest wall pain, 2, 13 but our patient did not.[rc.rcjournal.com]
Neglect
  • 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 Previously Neglected[books.google.com]
  • Broncholithiasis, a neglected cause of bronchoesophageal fistula. J.A.M.A. 160 1956 555 557 Crossref , Medline , Google Scholar 18. Lin C. S. , Becker W. H. Broncholith as a cause of fatal hemoptysis.[atsjournals.org]

Workup

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]

Treatment

  • Bronchoscopic stone removal was successful in 19%, whereas 21% of patients required no treatment.[ncbi.nlm.nih.gov]
  • The aim of this study was to evaluate the imaging diagnosis and surgical treatment of broncholithiasis.[ncbi.nlm.nih.gov]
  • After 9 months of antituberculosis treatment, the patient recovered and was still clinically well at the time of this writing.[ncbi.nlm.nih.gov]
  • Treatment ranges from conservative management (simple observation) to thoracotomy for patients in whom complications from stone erosion develop. The prognosis of patients with broncholithiasis is generally excellent.[ncbi.nlm.nih.gov]
  • Various treatment options are available and the choice of therapy should be made depending on the broncholith's size, mobility, location and local surgical expertise.[ncbi.nlm.nih.gov]

Prognosis

  • 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]
  • The prognosis of patients with broncholithiasis is generally excellent.[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]
  • AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE 197 , 2018 2018 Clinical Features and Prognosis of Nontuberculous Mycobacterial Pleuritis T Ando, M Kawashima, H Matsui, K Takeda, R Sato, N Ohshima, H Nagai, ...[scholar.google.co.jp]

Etiology

  • 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]
  • The etiology of broncholithiasis is discussed, with particular emphasis on the relationship between the organisms identified.[ncbi.nlm.nih.gov]
  • In Taiwan, pulmonary tuberculosis, one of the most common etiologies of broncholithiasis, is common. To our knowledge, no report on broncholithiasis can be found in literature in this country.[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]
  • Demonstrated here and three such cases of "recurrent hemoptysis of unknown etiology,". The broncholith in each case was clearly demonstrated only by the thoracic computed tomography (CT).[ncbi.nlm.nih.gov]

Epidemiology

  • 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]
Sex distribution
Age distribution

Pathophysiology

  • 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]
  • , Tsuduki K, Mashimo S, Takahashi S, Minematsu N, Tateno H, Asano K, Fujishima S, Betsuyaku T Biomarkers : biochemical indicators of exposure, response, and susceptibility to chemicals 23(5) 414-421 2018年7月 [査読有り] Allergic bronchopulmonary mycosis - pathophysiology[researchmap.jp]

Prevention

  • Early diagnosis and treatment will prevent the severe complications that can occur from continued observation.[ncbi.nlm.nih.gov]
  • 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]
  • […] 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]
  • Tissue interposition during surgical closure prevents recurrence.[nature.com]
  • Early recognizing ABPA is mainly based on clinical suspicion, which is related with improvement of patient symptoms and prevention of sustained lung damage in ABPA [ 4 ].[e-sciencecentral.org]

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