A Case of Broncholithiasis Which Required Seven Bronchoscopic Removal Procedures During an 8-year Period

Abstract

Background. Previous broncholithiasis reports from Japan show that calcified lymph nodes following tuberculosis can be a major cause for disease. However, the number of cases of broncholiths derived from respiratory tract secretions are recently increasing. We herein describe a case of broncholith caused by secretions which required repeated bronchoscopic removal. Case. A 51-year-old female, with neither any history of tuberculosis infection or calcification of the mediastinal lymph nodes, presented with a history of severe scoliosis, and multiple, consecutive lower respiratory infections from a young age. Bronchiectasis and a broncolith was detected at age 38, and first bronchoscopic removal was performed at 43 years of age to improve her respiratory function. Bronchoscopic removal was performed seven times for same purpose during an 8-year period without any complications. The composition of the removed broncholith was primarily calcium carbonate. The broncholith has not recurred for more than two years after initiating medical enhancements to airway humidification and carrying out sputum removal techniques. Conclusion. Lingering secretions due to airway clearance dysfunction as a result of scoliosis and bronchiectasis was presumably the source of this broncholith. In this case, bronchoscopic removal was found to be a safe and practical treatment for extracting an unattached broncholith.