Broncholithiasis refers to the presence of calcified or ossified material within the tracheobronchial tree. This rare condition is more frequently reported in regions endemic for tuberculosis and histoplasmosis, where necrotizing granulomatous lymphadenitis may lead to dystrophic calcification and eventual erosion of calcified lymph nodes into the bronchial lumen. Clinical presentation is heterogeneous and ranges from incidental findings to hemoptysis, chronic cough, recurrent infection, and post-obstructive complications. We conducted a retrospective review of five patients diagnosed with broncholithiasis at our tertiary care center. Clinical records were reviewed for demographic characteristics, presenting symptoms, imaging findings, bronchoscopic interventions, microbiologic data when available, and short-term follow-up outcomes. Two patients presented primarily with hemoptysis, one with chronic cough and severe infectious complications, one with recurrent pneumonia and lobar collapse, and one was incidentally referred with an obstructing broncholith. All five cases were managed bronchoscopically using combinations of rigid or flexible bronchoscopy, forceps, balloon dilation, cryotherapy, topical hemostatic measures, and argon plasma coagulation when needed. Two patients also required video-assisted thoracoscopic surgery for empyema management rather than for broncholith extraction itself. Where available, microbiologic findings included Actinomyces and mixed molds, highlighting the risk of post-obstructive infection. These cases underscore the heterogeneous clinical spectrum of broncholithiasis and support bronchoscopy as the primary diagnostic and therapeutic modality in appropriately selected patients. Early recognition, multidisciplinary management, and attention to associated infectious complications may improve outcomes.

Acquired benign tracheoesophageal fistulas and bronchoesophageal fistulas (TEF) are typically associated with granulomatous mediastinal infections, 75% of which are iatrogenic. Candida albicans and Actinomyces are commonly occurring organisms, but are uncommon etiologies of TEF. Normal colonization and the slow growth characteristics of some species of these agents rarely result in infection, mycetoma, and broncholithiasis, and thus, delays in diagnosis and treatment are likely. Few reports describe C. albicans or Actinomyces spp. as the etiology of TEF or broncholithiasis. Herein, we report a case of benign acquired TEF secondary to coinfection of Candida and Actinomyces complicated by the formation of an actinomycetoma and broncholithiasis and a comprehensive literature review to highlight the unique nature of this presentation and offer a diagnostic algorithm for diagnosis and treatment of TEFs. Following a presentation of three months of productive cough, choking sensation, night sweats, and weight loss, a bronchoscopy revealed a fistulous connection between the esophagus and the posterior right middle lobe. Pathology identified a calcified fungus ball and a broncholith secondary to the co-infection of Candida and Actinomyces. This unique presentation of Candida and Actinomyces co-infection and the associated diagnostic algorithm are presented as education and a useful tool for clinicians.

Broncholithiasis due to pulmonary histoplasmosis causing central airway obstruction and broncho-mediastinal fistula is a rare complication in the pediatric population. A 16-year-old previously healthy female was referred to a university hospital for worsening cough and shortness of breath for over a two-year period. Radiologic investigation revealed a calcified subcarinal lymph node eroding into the left mainstem bronchus causing central airway obstruction and collapse of the left lower lobe. Direct laryngoscopy and bronchoscopy showed a large obstructive lesion in the left mainstem bronchus. Debulking of the endobronchial lesion was performed with neodymium-doped yttrium aluminum garnet (Nd:YAG) laser and cryotherapy. Pathology examination was consistent with broncholith. Great clinical and radiological response to the procedure was evident with complete re-expansion of the left lung and resolution of symptoms.

We report a case of nephrobronchial fistula complicated by the development of a broncholith within the lung, which led to hemoptysis and blood loss anemia. A 71-year-old man with a medical history of untreated urinary stones was admitted for flank pain, hemoptysis, blood loss anemia, and exacerbation of chronic pyelonephritis. Computed tomography showed staghorn calculi, terminal hydronephrosis, xanthogranulomatous pyelonephritis of the left kidney, nephrobronchial fistula, and large intraparenchymal pulmonary calcification. Surgical treatment was performed in two steps: nephrectomy and then left lower lobectomy. Pathological findings were suggestive of chronic inflammatory changes.

Broncholithiasis is a rare condition in which lymph nodes, cartilage or inhaled material in the bronchi become calcified. Removal of the broncholith is indicated when it causes symptoms such as hemoptysis and obstructive pneumonia. Although there are various methods for removing broncholiths, no international recommendations exist. We report a case of safe removal of broncholiths using a cryo-probe under rigid bronchoscopy. A 72-year-old man presented with blood-tinged sputum for 5 months. Chest computed tomography (CT) revealed collapse of the middle lung lobe. Flexible bronchoscopy demonstrated broncholiths at the orifice of the middle lobe. We successfully removed the broncholiths with a cryo-probe under rigid bronchoscopy without any complications. Our experience suggests that removal of broncholiths can be safely and successfully performed using a cryo-probe under rigid bronchoscopy.

A mucus plug caused by bronchial obstruction of a broncholith may mimic lung cancer, and bronchoscopic removal of the broncholith was useful for differential diagnosis.

Broncholithiasis is an unusual clinical condition characterized by the presence of calcified or ossified material within the airways. Multiple endobronchial broncholithiasis during active infection with tuberculosis is an extremely uncommon presentation. Bron-choscopy plays an important role in the diagnosis and management of broncholithiasis. Currently, there are no specific guidelines for the management of broncholithiasis. Here, we present a case report where multiple broncholiths were successfully removed in a staged manner via rigid bronchoscopy.

Broncholithiasis is a rare disease characterized by bronchial erosion or distortion due to hilar or parenchymatous calcification. When a broncholith has no mobility and there is a risk of major bleeding if removal is attempted, surgical intervention is required. Most operations for broncholithiasis are performed via a thoracotomy, and bronchial lithotripsy under complete video-assisted thoracoscopic surgery has been reported only rarely. We have experienced a case of broncholithiasis with severe obstructive pneumonia that was treated successfully by video-assisted thoracoscopic surgery. Thoracoscopic surgery is an effective treatment for broncholithiasis because it is minimally invasive and aids smooth recovery after surgery. When the adhesion between the pulmonary artery and the bronchus is highly advanced, it is advocated to cut them together using an endostapler.

A 60-year-old woman developed a pulmonary abscess due to broncholithiasis. It was treated by bronchoscopic broncholithectomy after antibiotic administration. Broncholithiasis is a rare disease and various treatment options are available, which include bronchoscopic broncholithectomy and surgery. Bronchoscopic broncholithectomy has proved to be more useful because it can be used to easily extract the broncholith by using a balloon and haemostasis can be obtained at the same time.