CTICasesBroncholithiasis Secondary to Histoplasmosis
Imaging findings
CT shows multiple calcified mediastinal and hilar lymph nodes, thickening of the anterior tracheal wall, and a calcified subcarinal mass protruding into and compressing the airway. Splenic calcifications are also present. Bronchoscopy confirms a calcified endobronchial mass (broncholith) with surrounding inflammation and bleeding, which was partially removed.
Key takeaways
Broncholithiasis typically results from the erosion of calcified peribronchial lymph nodes into the airway lumen, most commonly secondary to histoplasmosis in endemic areas. Patients usually present with hemoptysis, cough, or obstructive atelectasis, and airway obstruction can be managed bronchoscopically with mechanical debridement or laser.
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