Horiba M, Kuyama A, Matsumoto H, Kawai H, Okada C, Tada A, Kawahara S, Soda R, Takahashi K
Department Internal Medicine, National Minami-Okayama Hospital, 4066 Hayashima, Hayashima-cho, Tukubo-gun, Okayama, 701-0304, Japan.
Nihon Kokyuki Gakkai Zasshi. 2000 Dec;38(12):914-7.
A 53-year-old woman was admitted for recurrent hemoptysis and cough. The chest radiograph showed an infiltrative shadow in the left upper region. Chest tomogram and CT scan showed a small calcification and consolidation in the left upper lobe. Fiberoptic bronchoscopy revealed fresh hemorrhage from the left upper bronchus but no broncholith or bleeding point were detected. Since the symptoms had disappeared by 10 days after admission, the patient was discharged and followed up as an outpatient. Three weeks later, she spontaneously expectorated a stone 3 mm in maximum diameter, with an irregular surface. Analysis revealed that the stone's composition was 56% of calcium phosphate and 44% of calcium carbonate. Hemoptysis seemed to have been caused by the broncholith, which had originated as a calcification of a peribronchial lymph node that subsequently eroded its way into the airway. After lithoptysis, no recurrence has been observed.
一名53岁女性因反复咯血和咳嗽入院。胸部X光片显示左上区域有浸润性阴影。胸部断层扫描和CT扫描显示左肺上叶有小钙化灶和实变。纤维支气管镜检查发现左上支气管有新鲜出血,但未发现支气管结石或出血点。由于入院后10天症状消失,患者出院并作为门诊病人进行随访。三周后,她自行咳出一块最大直径3毫米、表面不规则的结石。分析显示结石成分中磷酸钙占56%,碳酸钙占44%。咯血似乎是由支气管结石引起的,支气管结石起源于支气管周围淋巴结钙化,随后侵蚀进入气道。咳出结石后,未观察到复发。