Correct!
2. Bronchoscopy
Bronchoscopy was performed to confirm the presence of brocholiths (Figure 4).
Figure 4. Multiple views of the distal left mainstem and LLL subsegmental bronchi showing a large broncholith extending into the bronchi with surrounding granulation.
Broncholithiasis is defined as the presence of calcified or ossified material within the lumen of the bronchus. It is usually formed by erosion and extrusion of a calcified adjacent lymph node into the bronchial lumen. Granulomatous mycobacterial or fungal infections are typical causes. Clinically, broncholiths can present with multiple nonspecific symptoms and signs - cough, fever, hemoptysis, purulent sputum, wheeze, or chest pain.
Untreated symptomatic broncholithiasis may lead to massive hemoptysis, bronchial fistula, bronchiectasis and/or recurrent infections. Treatment may vary from observation, to bronchoscopic removal, or surgery. Bronchoscopic removal is successful in 43% to 87% of cases.
In our patient, cardiothoracic surgery was consulted and she is being considered for a left lower lobectomy.
References