A Case of Asymptomatic Broncholithiasis with Fungal Infection Identified by a Chest CT Examination

Abstract

Background. The origin of a broncholith is erosion of the bronchus due to calcification of a lymph node or foreign material in the bronchus. However, there are a few reported cases of broncholithiasis due to a fungal infection. Additionally, many cases of broncholithiasis have respiratory symptoms, such as a cough and hemoptysis. It is also rare for asymptomatic broncholithiasis to be identified by a chest CT examination. Case. An abnormality was noted by a chest CT examination in a 61-year-old man and he was admitted to our hospital. Chest CT showed a calcified tumor in the left B¹⁺² bronchus and wedge-shaped consolidation in left S¹⁺². Bronchoscopy was performed for a detailed examination. A brown material was removed from the left B¹⁺²a using biopsy forceps and saline. The histopathological diagnosis was broncholithiasis and the broncholith was occupied by numerous hyphae from a fungus, such as Aspergillus. There was no recurrence of broncholithiasis after bronchoscopy. Conclusion. It is rare to identify an asymptomatic broncholithiasis found by chest CT and perform endoscopic stone removal. We must examine more cases to determine therapeutic indications for asymptomatic cases.