A 61-year-old man who had been treated for pneumonia several times was examined because radiographs and computed tomograms disclosed a mass-like shadow associated with a cavity in the left lingular segment. The lesion was resected by video-assisted thoracoscopic surgery because it was suspected of being a lung abscess that had caused repeated episodes of inflammation. The resected specimen revealed a severely dilated peripheral bronchus due to broncholithiasis. It is often difficult to diagnose a lesion as broncholithiasis on the basis of secondary changes or calcification without bronchoscopic data. We emphasize that broncholithiasis should be suspected when a shadow resembling a lung abscess associated with symptoms of recurrent infection is found.
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