Broncholithiasis

Abstract

In patients presenting the symptoms and physical findings of partial to complete bronchial obstruction, a broncholith should be considered as a possible etiologic factor in addition to the two entities usually considered, namely, an aspirated foreign body or a bronchial tumor.

In its strictest sense the term broncholithiasis refers to the formation of calculi in a bronchus. It is the accepted diagnostic term for patients having bronchial stones, although in the majority of cases the calculus originally develops extrabronchially, for which reason a few authors in the literature mention pneumoliths, pulmoliths, and lung calculus or lung stone. As the majority of patients with broncholithiasis frequently experience an asthmatoid type of wheeze, the term stone asthma is also used. Patients who are able to expel these stones by themselves experience a severe paroxysmal type of cough which the French have accurately described as “colique bronchique”. The occurrence of “lung stones” has been recognized since the days of Aristotle and Galen, but a comprehensive clinical report did not appear until Schenck¹ recorded his observations in 1600.

The entity is not very common as is indicated by the fact that Lloyd² found only 18 cases reported in the English literature between 1900 and 1930. Lloyd reported four cases in 1930, and since that time only four additional cases of broncholithiasis have been reported in the English literature. In the majority of these the diagnosis was made after the patient had expelled the stone himself. In most instances only a single or a few. . .