A case of broncholithiasis complicating hemoptysis

A 62-year-old male was admitted because of hemoptysis. The chest X-ray showed an infiltrative shadow in the right upper lung field. Tomograms and CT scans also showed an infiltrative shadow and small calcifications in the same field. Examination by bronchoscopy revealed bronchial bleeding from the depth of the right B1b. Although the detailed view was unclear due to bleeding, we did not find any growth or any mucosal abnormality. We examined only the bronchial washing cytology. The result was Papanicolaou class Ⅱ. However, we could not rule out malignancy, so we decided to perform a right upper lobectomy. A bron-cholith was seen in the B1b and a hematoma was also seen on its periphery. The stone components were calcium carbonate (74%) and calcium phosphate (26%), suggesting that the stone was caused by mucus retention.

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