Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content + • Presence of broncholiths (calculi) in tracheobronchial tree• Causes include: -Calcified parabronchial lymph node eroding into bronchial wall lumen (most common)-Severely inspissated mucus may calcify• Broncholiths may remain attached to bronchial wall, lodge in bronchus, or be expectorated (lithoptysis) +++ Symptoms and Signs + • Hemoptysis• Lithoptysis (30%)• Cough, sputum production, pleuritic chest pain• Fever, chills• Wheezing• Pneumonia may occur from obstructive broncholith +++ Imaging Findings + • Chest film: Hilar calcification, segmental atelectasis, pneumonia + • Diagnosis is confirmed with lithoptysis or presence of broncholith + • Chest film• Bronchoscopy to identify stone + • Treat underlying pulmonary disease• Treatment directed at removal of stone +++ Surgery + • Bronchoscopy successful 20% of time to remove stone-Risk is massive-Hemorrhage if attached to wall or use excessive force to remove• 80% require surgery: Bronchotomy and stone extraction or segmentectomy/ lobectomy +++ Indications + • Unable to remove via bronchoscopy (80% of cases)• Tracheoesophageal fistulas: Repair with intercostals muscle flap between airway and esophagus to prevent recurrence +++ Complications + • Hemoptysis, may be massive• Midesophageal traction diverticular• Tracheoesophageal fistula +++ Prognosis + • Excellent after surgery +++ References ++Galdermans D et al. Broncholithiasis: present clinical spectrum. Respir Med. 1990;84:155. [PubMed: 2371439] ++Martinez S. et al. Mucoid impactions: finger-in-glove sign and other CT and radiographic features. Radiographics. 2008 28(5):1369-82. [PubMed: 18794313] Your MyAccess profile is currently affiliated with '[InstitutionA]' and is in the process of switching affiliations to '[InstitutionB]'. Please click ‘Continue’ to continue the affiliation switch, otherwise click ‘Cancel’ to cancel signing in. Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Username? Forgot Password? Sign in via OpenAthens Sign in via Shibboleth