Management of broncholithiasis

Abstract

Broncholithiasis refers to the presence of calcified material that erodes into the lumen of the tracheobronchial tree or lung parenchyma, potentially causing inflammation and obstruction (1). Consequences from broncholithiasis range widely from being asymptomatic to life threatening such as recurrent pneumonias, hemoptysis, and bronchoesophageal fistula. Management varies depending upon several factors including patient symptoms, associated lung disease, and mobility of the broncholith within the airway, but typically involves either observation or intervention via bronchoscopy or thoracic surgery. This paper reviews the etiology, clinical presentation, radiologic appearance, and management of broncholithiasis. Definition and etiology The term broncholithiasis is the condition that arises when a broncholith causes airway irritation, obstruction, or erosion into adjacent structures (2). The vast majority of broncholiths are formed by the partial or complete erosion

Bronchoscopic Extraction of Multiple Endobronchial Broncholiths in A Patient with Active Pulmonary Tuberculosis

“…Various bronchoscopic methods have been described for the removal of broncholiths. Forceps, laser photocoagulation, and cryoprobe extraction have all been shown to help in extracting broncholiths [4,14]. Laser-assisted broncholithotripsy has also been described for removing impacted broncholiths [15].…”

Feasibility and long-term safety of Ho:YAG laser lithotripsy in broncholithiasis patients

“…The most common methods of treatment are therapeutic bronchoscopy and surgery. Most reports of therapeutic bronchoscopy indicate that broncholiths are treated as foreign bodies, removed using foreign body forceps, rigid forceps, or a Fogarty balloon catheter [3]. Jin et al [4] reported a treatment of intraluminal broncholith with a success rate of only 50%(2/4), Seventeen out of 19 patients with transluminal broncholiths received thoracotomy, only two patients received rigid bronchoscope.…”

The efficacy and safety of bronchoscopy for treating transluminal broncholiths

“…1 The calcified substances are derived from chronic necrotizing granuloma infection including tuberculosis, histoplasmosis and rare actinomycosis, which cause calcification of mediastinal and hilar lymph nodes. 2 Broncholiths are classified into intraluminal, transluminal and extraluminal acc-ording to the anatomy between calculus and bronchial lumen confirmed by chest CT or bron-choscopy. An intraluminal broncholith means that the stone is confined to the bronchia lumen, while an extraluminal broncholith means that the stone is located outside the bronchial lumen and does not penetrate the bronchial wall.…”

“…At present, the treatment methods of broncholithiasis mainly include bronchoscopy and surgical intervention. 2 Intraluminal broncholiths can be removed entirely or in part by biopsy forceps, foreign body forceps or net baskets under bronchoscope, with or without pretreatment of holmium laser lithotripsy. 6 Olson et al 7 have reported that intraluminal broncholiths can be removed by a rigid bronchoscope or flexible bronchoscope with a 100% success rate.…”

“…However, it is often difficult to remove a transluminal broncholith completely at one time with no complications such as massive hemorrhage and bronchial wall laceration. 2 We aim to explore the advantages and importance of the staged extraction of transluminal broncholiths via bronchoscopy. In this study, 28 patients with transluminal broncholiths were enrolled retrospectively in Lanzhou University Second Hospital between January 2010 and August 2018 to evaluate clinical presentation, imaging characteristics, treatment methods, outcomes and complications, exploring the efficacy and safety of the staged extraction of transluminal broncholiths via bronchoscopy.…”