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Broncholithiasis: review of the causes with radiologic-pathologic correlation.
Joon Beom Seo1, Koun-Sik Song, Jin Seong Lee
1Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Pungnap-dong, Songpa-gu, Seoul 138-736, Korea. seojb@www.amc.seoul.kr
Summary
Broncholithiasis involves calcified material in the airways, often causing obstruction. Computed tomography (CT) aids diagnosis by identifying endobronchial calcifications and associated airway issues.
Area of Science:
- Pulmonary Medicine
- Radiology
- Medical Imaging
Background:
- Broncholithiasis is characterized by calcified or ossified material within the bronchial lumen.
- Radiographic findings include airway obstruction, such as atelectasis, mucoid impaction, bronchiectasis, and expiratory air trapping.
Purpose of the Study:
- To describe the computed tomography (CT) findings suggestive of broncholithiasis.
- To outline the common causes and differential diagnoses of broncholithiasis.
Main Methods:
- Utilizing helical CT with thin sections (<3 mm) and multiplanar reformation to visualize the bronchial tree.
- Correlating endobronchial or peribronchial calcified nodules with signs of bronchial obstruction.
Main Results:
- CT strongly suggests broncholithiasis when endobronchial calcified nodules are present with bronchial obstruction.
- The most frequent cause is erosion from calcified adjacent lymph nodes, often linked to tuberculosis or histoplasmosis.
- Other causes include aspirated bone, calcified foreign material, or bronchial cartilage.
Conclusions:
- Accurate diagnosis of broncholithiasis relies on recognizing typical CT imaging features and understanding its diverse etiologies.
- Awareness of these findings and causes is crucial for appropriate patient management.