A case of bronchomycosis with large broncholithiasis

Abstract

A 72-year-old female was admitted to our hospital for a further examination of hemoptysis. Chest computed tomography showed a dilated left B³ bronchus filled with low-density material and large calcifications. Bronchoscopic study revealed broncholithiasis obstructing the orifice of the left B³band a yellowish cluster of bronchomycosis. Via bacterial study, the cluster was identified to be Aspergillus fumigatus. Considering the difficulty in the bronchoscopic removal of the broncholithiasis and the possible risk of recurrent bronchomycosis, we performed left upper division segmentectomy. Stone analysis revealed that 98% of the components were calcium carbonate. These results suggested that the bronchomycosis was secondary to the broncholithiasis that was caused by mucus retention resulting from repeated chronic inflammations with the bronchiectasis. Surgical treatment should be considered for bronchomycosis with obstructive bronchial disorders.