Broncholithiasis Assessed by Bronchoscopic Saline Solution Injection

Asymptomatic Broncholithiasis and Aspergillus Infection: A Case Report and Literature Review

Broncholithiasis coupled with Aspergillus infection is a rare disease of the respiratory system with complex pathogenesis and non-specific clinical manifestations that can be easily confused with other types of infectious diseases of the respiratory system. The lack of pertinent clinical manifestations in patients increases the risk of clinical misdiagnosis, omission, and incorrect treatment plan selection, which can result in permanent lung structural alterations and lung function decompensation and ultimately harm the lung. We report a rare case of asymptomatic broncholithiasis coupled with Aspergillus infection that was treated at our hospital and discuss the pathophysiology, diagnosis, differential diagnosis, and prognostic follow-up course. Furthermore, relevant studies from China and other countries, including this case, were reviewed. We gathered eight reports, summarized their significant diagnoses and treatments for broncholithiasis and broncholithiasis coupled with Aspergillus infection, and discussed their clinical features. Our study may help improve physicians' awareness of these types of diseases and serve as a resource for future diagnosis and treatment.

An endobronchial hamartoma observed using narrow band imaging under saline injection: A case report

A light blue line (LBL) was observed along the edge of a lesion using narrow band imaging under saline injection during bronchoscopy in an 82-year-old patient with a lobulated mass on the left B4. The histopathological diagnosis was hamartoma with ciliated bronchial epithelium, and we speculated that LBL appeared around the ciliated bronchial epithelium.

Broncholithiasis: Treatment Evaluation in 63 Patients

BACKGROUND

Broncholithiasis is a rare disease defined as the presence of calcified material (broncholith) within the tracheobronchial tree. We described our experience in broncholithiasis to provide a more effective clinical basis for the management of this condition.

METHODS

We retrospectively reviewed the clinical characteristics, treatments, and outcomes of patients with broncholithiasis at Xiangya Hospital in China from May 2009 to November 2019.

RESULTS

Sixty-three patients were enrolled in this study with a median age of 57 years. Cough (57.1%) was the most common symptom of broncholithiasis, followed by hemoptysis (23.8%). Tuberculosis was the most common comorbidity (38%), while 21 patients (30.0%) did not exhibit underlying diseases. Broncholiths within the bronchus led to airway dilation (19.0%), obstructive atelectasis (46.0%), and pneumonia (30.2%). The condition of most patients improved after undergoing endoscopic removal (76.5%) of the broncholiths. The condition of three patients (100%) improved after the surgical removal of the broncholiths. Of the 38 patients (60.3%) who failed to receive removal of broncholiths, 16 received anti-infection treatment, and the other 22 received observation. Most patients (50.0%) who were treated with anti-infectives showed an improvement, whereas the condition of 33.3% of patients who did not receive treatment worsened.

CONCLUSION

Broncholithiasis is a benign bronchial disease that can cause complications. Endoscopic removal of broncholiths is considered as initial therapy and surgical removal is suggested as a second-line treatment. Treatment with anti-infectives is required for patients who fail to receive removal of broncholiths.

Use of saline to evaluate a cavity due to Mycobacterium kansasii infection during ultrathin bronchoscopy and endobronchial ultrasonography

A 28-year-old man had a cavitary lesion in the upper right lobe with a tree-in-bud appearance on chest computed tomography (CT). Diagnostic bronchoscopy was performed. An ultrathin bronchoscope in the right B2aiiβxyy reached the cavity. We filled the cavity with saline under direct bronchoscopic visualization. We suspected a blood vessel was present in the cavity wall based on narrow-band imaging. Bronchial lavage of the cavity was performed. Next, endobronchial ultrasonography (EBUS) using a guide sheath was performed with a thin bronchoscope. EBUS showed a pulsating blood vessel in the cavity wall. Bronchial lavage collected with ultrathin and thin bronchoscopy revealed Mycobacterium kansasii. Observation of vessels in the wall of a cavitary lesion with ultrathin bronchoscopy and EBUS may be useful for avoiding severe bleeding associated with biopsy of a cavitary lesion.

Diagnosis of pulmonary aspergillosis-related broncholithiasis in a child undergoing bronchoscopy: A case report

RATIONALE

Broncholithiasis is a rare disease and is characterized by calcification in the tracheobronchial tree. This disease has a predilection in the adult and occurrence is rare in children. Considering its infrequency, we report a rare clinical case, with the aim of sharing our experience during the diagnosis and treatment procedures.

PATIENT CONCERNS

We report a 9-year- and 6-month-old girl who complained of chronic cough and recurrent wheeze for 2 months.

DIAGNOSIS

Bronchialithiasis were found under bronchoscope. Pathologic examination revealed aspergillosis.

INTERVENTIONS

The stone and surrounding granulation tissue were removed using a bronchoscope and the patient was treated with antifungal therapy.

OUTCOMES

The patient was in good general health without any clinical symptoms during the follow-up period.

LESSONS

Pulmonary Aspergillus infection can cause bronchiolithiasis. Stones were removed under bronchoscope, and anti-Aspergillus therapy was effective.