CTICasesBroncholithiasis
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Imaging findings
Chest CT shows a small, calcified broncholith within a left upper lobe bronchus associated with a surrounding ground-glass and solid nodular opacity, mimicking an adenocarcinoma. Ipsilateral calcified hilar and mediastinal lymph nodes are also present. Follow-up imaging reveals complete resolution of the ground-glass opacity, confirming it represented transient parenchymal hemorrhage.
Key takeaways
Broncholithiasis, typically caused by the erosion of a calcified lymph node into an adjacent bronchus (commonly from prior histoplasmosis or tuberculosis), can present with hemoptysis and cause localized parenchymal hemorrhage that closely mimics a neoplastic nodule or mass. Reviewing prior imaging for stable calcifications and obtaining short-term follow-up can confirm the transient nature of the surrounding hemorrhage.
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