Attia S, Boussoffara L, Fkih L, Belhabib D, Fenniche S, Megdiche M L
Service IBN Nafiss, Hôpital Abderrahmen Mami, Ariana, Tunisie.
Rev Mal Respir. 2006 Sep;23(4 Pt 1):348-52. doi: 10.1016/s0761-8425(06)71601-1.
Broncholithiasis is defined as the presence of calcified material in the bronchial lumen. The aim of our work was to study the clinical, radiological and therapeutic aspects of broncholithiasis.
We report the histories of 6 patients identified over 14 years (1990-2004). They included 4 men and 2 women with an average age of 50 years. A past history of pulmonary tuberculosis was found in 2 cases. The presenting symptom was haemoptysis in 4 patients. Fibreoptic bronchoscopy was performed in all patients and broncholiths were found in two. Thoracic CT scan was performed in 5 patients and in 3 showed hilar and parenchymal calcification, suggesting the diagnosis of broncholithiasis. The diagnosis was confirmed in 2 patients by bronchoscopy, in 2 others by surgical biopsy and in the remaining 2 by the CT appearances. Three patients were operated on: 2 for diagnosis and the third for haemostasis. Pulmonary tuberculosis was discovered in 2 patients, one by culture and the other by surgical biopsy. The outcome was satisfactory in all cases.
Broncholithiasis presents a problem of differential diagnosis from other pulmonary pathologies on account of misleading clinical, endoscopic and radiological features.
支气管结石症定义为支气管腔内存在钙化物质。我们这项工作的目的是研究支气管结石症的临床、放射学及治疗方面的情况。
我们报告了在14年(1990 - 2004年)期间确诊的6例患者的病史。其中包括4名男性和2名女性,平均年龄50岁。2例患者有肺结核病史。4例患者的主要症状为咯血。所有患者均接受了纤维支气管镜检查,其中2例发现支气管结石。5例患者进行了胸部CT扫描,3例显示肺门和实质钙化,提示支气管结石症的诊断。2例患者通过支气管镜检查确诊,另外2例通过手术活检确诊,其余2例通过CT表现确诊。3例患者接受了手术:2例为诊断目的,第3例为止血。2例患者发现肺结核,1例通过培养确诊,另1例通过手术活检确诊。所有病例的结果均令人满意。
由于具有误导性的临床、内镜及放射学特征,支气管结石症存在与其他肺部疾病进行鉴别诊断的问题。