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Broncholithiasis: CT features in 15 patients.

D J Conces1, R D Tarver, V A Vix

  • 1Department of Radiology, Indiana University Medical Center, Indianapolis 46202-5253.

AJR. American Journal of Roentgenology
|August 11, 1991
PubMed
Summary

Computed tomography (CT) effectively identifies broncholithiasis, a condition involving calcified lymph nodes eroding or distorting bronchi. Thinner CT sections improve localization of these endobronchial or peribronchial nodes, aiding diagnosis when other methods fail.

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Area of Science:

  • Radiology
  • Pulmonology
  • Medical Imaging

Background:

  • Broncholithiasis is a rare condition characterized by calcified peribronchial lymph nodes.
  • These nodes can erode into bronchi or cause bronchial distortion.
  • The primary diagnostic challenge lies in visualizing the calcified nodes and their relationship to the bronchial tree.

Purpose of the Study:

  • To evaluate the diagnostic utility of computed tomography (CT) in identifying broncholithiasis.
  • To determine the specific CT findings associated with broncholithiasis.
  • To assess the effectiveness of different CT collimations in diagnosing the condition.

Main Methods:

  • Retrospective review of chest radiographs and CT scans from 15 patients with confirmed broncholithiasis.

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  • Analysis of CT findings, including calcified lymph nodes, bronchial distortion, and signs of obstruction.
  • Correlation of CT findings with bronchoscopy and surgical results where available.

    • Main Results:

    • CT identified calcified lymph nodes in all 15 patients.
    • CT correctly localized 6 of 10 endobronchial nodes and 4 of 5 peribronchial nodes.
    • CT revealed secondary findings such as atelectasis (11 patients), infiltration (4), bronchiectasis (4), and air trapping (1).
    • Thinner CT sections (0.5 cm) were found to decrease volume averaging, improving the visualization of the lymph node-bronchus relationship.

    Conclusions:

    • Computed tomography is a valuable tool for diagnosing broncholithiasis, especially when bronchoscopy is inconclusive.
    • CT can accurately detect calcified lymph nodes and associated bronchial abnormalities.
    • Utilizing thinner CT sections enhances the ability to delineate the precise relationship between calcified nodes and the bronchi.