Cahill B C, Harmon K R, Shumway S J, Mickman J K, Hertz M I
University of Minnesota, Minneapolis 55455.
Am Rev Respir Dis. 1992 Mar;145(3):719-21. doi: 10.1164/ajrccm/145.3.719.
Broncholithiasis can result in airway obstruction through the erosion of calcified lymph nodes into the bronchial lumen or by extrinsic compression of the tracheobronchial tree. We report an unusual case of broncholithiasis in a patient with silicosis who developed airway obstruction from endobronchial polypoid masses of granulation tissue adjacent to calcified mediastinal lymph nodes. The production of granulation tissue may have been the result of broncholiths in the early stages of erosion into the tracheobronchial tree. Efforts to ablate the endobronchial polyps using YAG laser phototherapy were only temporarily successful and surgical removal of the calcified mediastinal lymph nodes was required to halt further polyp growth. Surgical specimens grew Mycobacterium avium-intracellulare (MAI), a common pathogen in patients with silicosis. MAI may have contributed to the local inflammatory milieu provoking the exuberant tissue response.
支气管结石症可通过钙化淋巴结侵蚀进入支气管腔或气管支气管树的外部压迫导致气道阻塞。我们报告一例矽肺患者发生支气管结石症的罕见病例，该患者因钙化纵隔淋巴结附近的支气管内息肉样肉芽组织肿块而出现气道阻塞。肉芽组织的产生可能是支气管结石在侵蚀气管支气管树早期阶段的结果。使用YAG激光光疗消融支气管内息肉的努力仅取得了暂时成功，需要手术切除钙化纵隔淋巴结以阻止息肉进一步生长。手术标本培养出鸟分枝杆菌复合群（MAI），这是矽肺患者的常见病原体。MAI可能促成了局部炎症环境，引发了旺盛的组织反应。
