Two Cases of Surgically Treated Broncholithiasis of Different Origin

Abstract

We experienced two cases of broncholithiasis. Case 1 was a 64-year-old male who was admitted with cough. The chest radiograph showed a tumor-like shadow 6×5cm in size in the left lower lung field. Bronchoscopy revealed obstruction of B^<10>. Obstructive pneumonia or pulmonary suppuration due to inflammatory bronchial stenosis was suspected, but lung cancer could not be ruled out. Left lower lobectomy was performed. The histological diagnosis was organized obstructive pneumonia due to a broncholith (B^<10>). The structure of the decalcificated broncholith (silver stain) suggested that it was derived from calcified lymph node. Case 2 was a 41-year-old male with continuous hemoptysis. The chest radiograph showed calcifications near right B^7 and a pneumonia-like shadow in S^7. Bronchoscopically, right B^7 B^8 and B^9 were obstructed by a blood clot. Since hemoptysis continued after admission, right lower lobectomy was performed. A broncholith was found in the lumen of B^7, which had a shape of a bronchial plug. The distal part of B^7 was dilated and filled with calcigerous mucus. The broncholith seemed to be caused by calcification of mucus in the bronchus. It was proved by calcium analysis that more than 98% of this broncholith consisted of calcium carbonate.