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Left sleeve Basal segmentectomy for broncholithiasis.
Authors:Masao Chujo  Shin-Ichi Yamashita  Yozo Kawano  Michiyo Miyawaki  Takayuki Imakiire  Katsunobu Kawahara
Affiliation:Department of Oncological Science (Surgery 2), Oita University Faculty of Medicine, Oita, Japan.
Abstract:Broncholithiasis is an uncommon pulmonary problem that may present with life-threatening complications. We report one case of broncholithiasis. A 49-year-old female presented with hemoptysis. Chest X-ray and computed tomography (CT) showed left interlobar lymph node calcification near the interlobar pulmonary artery, and calcification continued into the basal bronchus. Bronchoscopy demonstrated pedunculated granulation tissue in the left B8 bronchus obstructing the lumen. We did not recommend endobronchial removal because of the risk of bleeding, so we proposed surgical treatment. We performed left basal segmentectomy associated with bronchoplasty to preserve pulmonary function. It is important to gain proximal control of the pulmonary artery before dissection of its branches and to approach the pulmonary artery from the periphery to avoid massive intraoperative bleeding. The intrabroncholuminal stone was composed of 61% calcium carbonate and 39% calcium phosphate. The postoperative course was not eventful, and the bronchoscopical findings confirmed a good surgical outcome.
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