Nollet A S, Vansteenkiste J F, Demedts M G
Department of Pulmonology, University Hospital Gasthuisberg, Catholic University, Leuven, Belgium.
Respir Med. 1998 Jul;92(7):963-5. doi: 10.1016/s0954-6111(98)90197-4.
Broncholithiasis is a rare but distinct and potentially dangerous pulmonary problem that still needs to be considered in the differential diagnosis of some patients with bronchial obstruction. Broncholiths originate from calcified material in peribronchial lymph nodes eroding into the tracheobronchial tree. The clinical and chest X-ray signs are usually non-specific, but the diagnosis can nowadays be made based on clinical suspicion, CT-scan and fibre-optic bronchoscopy findings, so that a malignant cause of airway obstruction can be ruled out. The removal of broncholiths during fibre-optic bronchoscopy is seldom possible and rather dangerous. They can be removed safely by rigid bronchoscopy with the aid of Nd-YAG laser photocoagulation. Thoracotomy is indicated in complicated cases with fistula formation or severe bleeding.
支气管结石症是一种罕见但独特且具有潜在危险性的肺部疾病，在一些支气管阻塞患者的鉴别诊断中仍需加以考虑。支气管结石源于支气管周围淋巴结内的钙化物质侵蚀进入气管支气管树。临床和胸部X线征象通常不具有特异性，但如今可根据临床怀疑、CT扫描和纤维支气管镜检查结果做出诊断，从而排除气道阻塞的恶性病因。在纤维支气管镜检查期间很少能够取出支气管结石，而且相当危险。借助钕钇铝石榴石激光光凝，通过硬质支气管镜可安全取出结石。对于形成瘘管或严重出血的复杂病例，需行开胸手术。
