Advances in the diagnosis and treatment of broncholithiasis.

In order to determine the present clinical spectrum of broncholithiasis and the impact that chest computed tomographic (CT) scans, laminograms , and fiberoptic bronchoscopy ( FOB ) have had on the diagnosis and treatment of this entity, we reviewed our experience between 1970 and 1982. Nineteen patients were identified with this diagnosis. Cough, hemoptysis, and obstructive pneumonia were the most common presentations. Lithoptysis occurred in only 3 patients. The chest radiographic findings were nonspecific, but in 8 of the 19 patients, laminograms or chest CT scans helped establish the diagnosis; FOB was performed on 18 patients and was abnormal in each case, with 8 intrabronchial calcifications identified. However, FOB has limited therapeutic indications in this disorder. Depending on the patient's clinical status and underlying lung disease, observation, bronchoscopic removal of the stone, or surgical resection may be indicated.