Title:Broncholithiasis: From the Age of Aristotle to the Era of Surgical Pathology
Volume: 12
Issue: 2
Author(s): Christopher Hartley, Adam V. Regenmorter and Nagarjun Rao
Affiliation:
Keywords:
Broncholithiasis, pathology, calcification, colonization, superinfection.
Abstract: Broncholithiasis is a rare pulmonary condition caused predominantly by
erosion of calcified perihilar and mediastinal lymph nodes into the bronchial
lumen. The condition presents clinically in myriad ways including expectoration of
stones, persistent cough, hemoptysis, pneumonia, obstructive respiratory failure,
bronchoesophageal fistula or even massive hemorrhage. The clinical, radiographic,
bronchoscopic and gross features have the potential for a mistaken diagnosis of
bronchogenic carcinoma. Calcification of peri-hilar and mediastinal lymph nodes
is most often caused by chronic granulomatous infections, particularly
Mycobacterium tuberculosis and Histoplasma capsulatum. The stones act as nidus
for colonization or superinfection with other microorganisms including
Actinomyces spp. and Aspergillus spp. Bacterial, fungal, and mycobacterial special stains and
microbiologic culture are essential in the work up of broncholithiasis.
