1/13. Broncholithiasis: rare but still present.Broncholithiasis is a rare but distinct and potentially dangerous pulmonary problem that still needs to be considered in the differential diagnosis of some patients with bronchial obstruction. Broncholiths originate from calcified material in peribronchial lymph nodes eroding into the tracheobronchial tree. The clinical and chest X-ray signs are usually non-specific, but the diagnosis can nowadays be made based on clinical suspicion, CT-scan and fibre-optic bronchoscopy findings, so that a malignant cause of airway obstruction can be ruled out. The removal of broncholiths during fibre-optic bronchoscopy is seldom possible and rather dangerous. They can be removed safely by rigid bronchoscopy with the aid of Nd-YAG laser photocoagulation. thoracotomy is indicated in complicated cases with fistula formation or severe bleeding.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
2/13. Diffuse calcification of the airways.Airway calcification is usually restricted to the cartilaginous conducting portion of the bronchial tree. Alternatively, calcification of the alveoli is a relatively common consequence of calcium and phosphate imbalance. We wish to report an unusual case in which diffuse calcification of the entire bronchial tree, absent alveolar calcification, was identified in a patient with renal dysfunction. Pathologists should not exclude metastatic calcification when considering the etiology of bronchial calcification.- - - - - - - - - - ranking = 2keywords = tree (Clic here for more details about this article) |
3/13. warfarin-induced tracheobronchial calcification.Calcification of the trachea and proximal bronchi is a common, normal finding on chest radiographs in the elderly population, especially in women. More extensive airway calcification is also a rare manifestation of many pathologic conditions. The authors report a case of pathologic tracheobronchial calcification associated with long-term warfarin therapy. Chest radiographs showed prominent, diffuse calcification of the tracheobronchial tree. Computed tomography showed extensive calcification of the airway walls, extending from the trachea to the lung periphery.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
4/13. Extensive subcutaneous soft tissue calcification in a neonate following hypothermia: case report.A ten-hour old newborn found in the street where a dog was savaging him, was brought to Black Lion Hospital in 1998. The history, physical findings and radiological features suggested widespread subcutaneous fat necrosis, which later became calcified. Although this is a rare condition, medical workers need to be aware of the possibility of this self-limiting disease, which may occur in abandoned and hypothermic neonates.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
5/13. Tracheobronchial obstruction due to silicosis.Broncholithiasis can result in airway obstruction through the erosion of calcified lymph nodes into the bronchial lumen or by extrinsic compression of the tracheobronchial tree. We report an unusual case of broncholithiasis in a patient with silicosis who developed airway obstruction from endobronchial polypoid masses of granulation tissue adjacent to calcified mediastinal lymph nodes. The production of granulation tissue may have been the result of broncholiths in the early stages of erosion into the tracheobronchial tree. Efforts to ablate the endobronchial polyps using YAG laser phototherapy were only temporarily successful and surgical removal of the calcified mediastinal lymph nodes was required to halt further polyp growth. Surgical specimens grew mycobacterium avium-intracellulare (MAI), a common pathogen in patients with silicosis. MAI may have contributed to the local inflammatory milieu provoking the exuberant tissue response.- - - - - - - - - - ranking = 2keywords = tree (Clic here for more details about this article) |
6/13. Off pump coronary artery bypass grafting in a patient with tracheopathia osteoplastica.Tracheopathia osteoplastica is a rare disease of the tracheobronchial tree, which is often misdiagnosed and recognised only at post-mortem. We report the case of a 66-year-old man with this condition, mistakenly thought to be suffering from chronic bronchiectasis. He underwent successful coronary artery bypass grafting for unstable angina using an off-pump technique. A case report and brief literature review is presented.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
7/13. Petrified ears in a patient with Keutel syndrome: temporal bone CT findings.We present unusual imaging findings of petrified ears in a 9-year-old girl with Keutel syndrome. The patient presented for a temporal bone study for hearing loss. CT scan showed middle and inner ear abnormalities along with extensive and unsuspected calcification of the external ears and ossicular ligaments. On further investigation, the patient was found to have diffuse cartilage calcification in the larynx and tracheobronchial tree, brachytelephalangism and peripheral pulmonary stenosis suggestive of Keutel syndrome. Confirmation was obtained by mutation analysis.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
8/13. The use of multiple "buddies" during transradial angioplasty in a complex calcified coronary tree.We report our experience in transradial coronary angioplasty on a tortuous, calcified coronary tree in a patient who had been turned down for surgical revascularization. In view of the complexity of the coronary anatomy, successful completion of the procedure required plaque modification with the use of rotational atherectomy in the left anterior descending coronary artery, and the use of an inflated buddy balloon in the circumflex artery. The latter represents a novel, simple, and inexpensive technique, which may allow successful advancing of coronary stents in calcified and tortuous coronary arteries.- - - - - - - - - - ranking = 5keywords = tree (Clic here for more details about this article) |
9/13. Tracheopathia osteoplastica: familial occurrence.Tracheopathia osteoplastica is an unusual disease characterized by cartilaginous or bony projections into the tracheobronchial lumen, with sparing of the posterior membranous portion of the tracheobronchial tree. The cause of this disorder is unknown. The diagnosis is seldom made because of the chronic and asymptomatic nature of the condition. More than 90% of the cases are diagnosed at postmortem examination. Symptoms may include dyspnea, coughing, hemoptysis, hoarseness, and wheezing. tomography of the trachea may reveal beaded calcification of the tracheobronchial cartilages. bronchoscopy is diagnostic. Histologically, the abnormal growths show heterotopic bone formation. No known treatment is available. We describe two female patients, one with hemoptysis and another with asthmalike symptoms, in both of whom bronchoscopy established the diagnosis of tracheopathia osteoplastica. The first patient had recurrent episodes of pneumonia attributable to bronchial obstruction by bony projections. In the second patient, removal of large lesions that obstructed the upper part of the trachea relieved the dyspnea. Of interest is the fact that the first patient was the biologic mother of the second. To our knowledge, this constitutes the first report of familial occurrence of tracheopathia osteoplastica.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
10/13. Coughing up a stone. What to do about broncholithiasis.Broncholithiasis, a disease that is probably much more common than has been reported, is most often associated with pulmonary infections, for example, tuberculosis and histoplasmosis. Stones originate from calcified peribronchial lymph nodes that erode into the tracheobronchial tree, but lithoptysis occurs infrequently. The most common symptoms are persistent cough and hemoptysis, sometimes followed by findings of obstructive pneumonia (fever, chills, and purulent sputum). Physical findings are nonspecific, and radiologic findings are varied. Complications include formation of a fistula between the respiratory tract and the esophagus or aorta and obstructive pulmonary symptoms. Treatment ranges from conservative management (simple observation) to thoracotomy for patients in whom complications from stone erosion develop. The prognosis of patients with broncholithiasis is generally excellent.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
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