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Chinese Journal of Lung Diseases(Electronic Edition) ›› 2024, Vol. 17 ›› Issue (04): 595-599. doi: 10.3877/cma.j.issn.1674-6902.2024.04.017

• Original Article • Previous Articles     Next Articles

Diagnosis, treatment, and prognostic analysis of broncholithiasis

Shuang Yan1, Hua Jiang1,(), Jian Chen1, Lei Pan1, Faguang Jin1   

  1. 1. Department of Pulmonary and Critical Care Medicine, Tangdu Hospital, The Air Force Military Medical University, Xi′an 710038, China
  • Received:2023-12-28 Online:2024-08-25 Published:2024-09-29
  • Contact: Hua Jiang

Abstract:

Objective

To analyze the clinical characteristics, diagnostic and therapeutic methods, and prognosis of patients with broncholithiasis.

Methods

It was reviewed that 26 patients diagnosed with broncholithiasis and treated at the Department of Pulmonary and Critical Care Medicine, Tangdu Hospital, Air Force Medical University from January 2010 to December 2021, and collected their clinical data, treatment procedures, and outcomes.

Results

The main clinical features of the 26 patients included cough in 24 cases (92.31%), sputum production in 19 cases (73.08%), and dyspnea in 9 cases (34.62%). Radiological findings showed intrabronchial high-density shadows in 17 cases (65.38%), associated with lung collapse in 8 cases (30.77%), bronchial stenosis in 5 cases (19.23%), consolidation in 4 cases (15.38%), cavity formation in 1 case (3.85%), and pleural effusion in 1 case (3.85%). Locations of bronchial stones included 15 cases in the right bronchus (57.69%) and 10 cases in the left bronchus (38.46%), specifically 6 cases in the left upper lobe (23.08%), 6 cases in the right upper lobe (23.08%), 5 cases in the right middle lobe (19.23%), 4 cases in the left main bronchus (15.38%), 3 cases in the right lower lobe (11.54%), 1 case in the right middle segment (3.85%), and 1 case of multifocal airway stones (3.85%). Treatment modalities included single intervention in 15 cases (57.69%), dual interventions in 9 cases (34.62%), three or more interventions in 2 cases (7.69%), and surgery in 1 case (3.85%). Use of single-forceps biopsy was noted in 10 cases (38.46%), and combined with other therapies in another 10 cases (38.46%). After treatment, complete clearance of bronchial stones was achieved in 14 cases (53.85%), partial clearance in 10 cases (38.46%), and no clearance in 2 cases (7.69%). There were no major complications such as hemorrhage, heart failure, or malignant arrhythmias. There was a statistically significant improvement in airway narrowing scores and dyspnea indices after treatment (P<0.05).

Conclusion

Broncholithiasis is a rare pulmonary disease with nonspecific symptoms and a generally favorable prognosis, which can be effectively managed with bronchoscopic interventions, with a low recurrence rate. Surgical resection should be considered for cases where stones invade vessels or when endoscopic removal fails.

Key words: Broncholithiasis, Bronchoscopy, Airway stenosis, Treatment, Prognosis

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