Broncholith Removal Using a Cryoprobe in Combination With Biopsy Forceps in a Patient With Immune Thrombocytopenia: A...

Broncholithiasis is a rare respiratory condition usually caused by calcified lymph nodes eroding into the bronchial lumen, often following pulmonary tuberculosis or histoplasmosis infections. Patients may be asymptomatic or present with haemoptysis, recurrent respiratory infections or airway obstruction, for which bronchoscopic or surgical treatment may be required. No internationally standardized guidelines currently exist for broncholith removal. We report a 63-year-old woman with previous pulmonary tuberculosis, recurrent haemoptysis and thrombocytopenia that was subsequently diagnosed as immune thrombocytopenia. Chest CT showed a 9 × 8 mm calcified lesion in the distal anterior segmental bronchus of the right upper lobe. Bronchoscopy revealed a transbronchial broncholith surrounded by granulation tissue and firmly attached at its base. The broncholith was removed using a cryoprobe and biopsy forceps under flexible bronchoscopy, with minor bleeding. This case suggests that broncholith removal under flexible bronchoscopy using a cryoprobe combined with biopsy forceps may be feasible in patients with thrombocytopenia.