A Case of Broncholiths Extracted by Fiberoptic Bronchoscopy

Abstract

A 61-year-old woman complained of cough. Her chest X-ray revealed collapse of the right middle and lower lobes and several calcified nodules in the right hilum. Chest CT scan demonstrated one of these calcified nodules to be situated at the orifice of truncus intermedius. Bronchoscopic examination revealed an obstruction by a broncholith with an irregular surface and a residual stone in the bronchial wall on the mediastinal side at the orifice of the truncus intermedius. We attempted bronchoscopic extraction of the stone, but the stone moved into the peripheral bronchus and became invisible due to the stenosis of the truncus intermedius. Repeated bronchoscopic examination showed the broncholith tightly obstructing the orifice of the right B^<9+10>. After several bronchoscopic procedures, the extraction of the stone was carried out successfully using a cytology curette and grasping forceps. The broncholith mainly consisted of calcium phosphate. The decalcified structure appeared to be that of a lymph node, which suggests that the calcified lymph node penetrated into the lumen of the truncus intermedius and eventually formed a broncholith.