기관지결석증에 대한 연구

Abstract

Objectives: Broncholithiasis is defined as a condition in which an concretion is present within a bronchus or a cavity in the lung communicating with a bronchus, It almost invariably represents the end stage of healing of granulomatous pulmonary diseases such as histioplasmosis or tuberculosis. Broncholiths are found with almost equal frequency in men and women, mostly in the fifth or sixth decade. Common symptoms are chronic cough, hemoptysis and sputum. Lithoptysis, which is pathognomic, is rare. The chest radiograph mostly shows calcified masses around the bronchi. In most cases, because of no significant symptoms or complication, observation may be the best course but bronchoscopic removal or surgical intervention are indicated in some instances. We report here the cases of broncholithiasis in which some clinical characteristics were observed. Methods: From January 1981 to December 1993, 13 patients with broncholithiasis had undergone the analysis for clinical manifestation, bronchoscopic fin- ding, treatment modality and follow-up status. Results : Broncholithiasis was distributed evenly from the fourth to the sixth decade and it developed in association with tuberculosis in 53.8%. Lithoptysis occurred in only 23.1% and calcification was found radiographically in 38.3%. Various positive findings, noted in all patients undergoing flexible bronchoscopy, included visualization of the broncholith, polypoid granulation tissue, stenotic or narrowed bronchi or blood clots. While 6 patients with conservative care only continued to have symptoms, an excellent result was evident in 3 of 7 patients in whom broncholith was removed after treatment or spontaneously. Conclusion: A clinical awareness of the manifestations of broncholithiasis will result in early diagnosis and treatment. As indicated, if the broncholith can be removed before irreversible distal bronchial and parenchymal damages occur, the long-term outlook for symptomatic relief is excellent.