Etiology
- Histoplasmosis (see [[Histoplasmosis]])
- Most common cause in US
- Usually calcified node eroding into airway
- Tuberculosis (see [[Tuberculosis]])
- Usually calcified node eroding into airway
- Coccidioidomycosis (see [[Coccidioidomycosis]])
- Usually calcified node eroding into airway
- Cryptococcosis (see [[Cryptococcosis]])
- Usually calcified node eroding into airway
- Blastomycosis (see [[Blastomycosis]])
- Actinomycosis (see [[Actinomycosis]])
- Usually calcified node eroding into airway
- Nocardiosis (see [[Nocardiosis]])
- Silicosis (see [[Silicosis]])
- Usually calcified node eroding into airway
- Ossifying Bronchial Carcinoid (see [[Bronchial Carcinoid]])
- Foreign Body (see [[Foreign Body]])
- Calcification of foreign body
- Renal Stone Erosion Into Airway
- Necrotizing Pneumonia (see [[Necrotizing Pneumonia]])
- Uncommon etiology
- Usually calcified cartilage eroding into airway
- Bronchiectasis (see [[Bronchiectasis]])
- Uncommon etiology
- Usually calcified cartilage eroding into airway
Physiology
- Presence of calcified (85-90% calcium phosphate and 10-15% calcium carbonate: similar to bone) fragment of tissue (either lung tissue or lymph node) within a bronchus
- May produce partial or complete obstruction
Diagnosis
- FOB: indicated for hemoptysis, persistent cough, or to rule out other causes
- Some stones may be removed bronchoscopically
- CXR/Chest CT: may demonstrate mediastinal adenopathy (with or without calcification)
Clinical
- Cough with Purulent Sputum (occasional expectoration of stones or gritty material):
- Hemoptysis (see [[Hemoptysis]])
- Fever:
- Symptoms of Airway Obstruction (see [[Obstructive Lung Disease]])
Treatment
- Supportive:
- Antibiotics for post-obstructive pneumonia
- Surgery: may be required for persistent or recurrent cases