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Esophago-pulmonary fistula manifesting as recurrent pneumonias and migrating mediastinal calcifications

Jadd Kebbe, Sai Yendamuri, Charles Roche, Kassem Harris, Samjot Singh Dhillon
  • Jadd Kebbe
    University of Oklahoma Health Sciences Center, United States
  • Sai Yendamuri
    Roswell Park Cancer Institute, Department of Thoracic Surgery, United States
  • Charles Roche
    Roswell Park Cancer Institute, Department of Radiology, United States
  • Kassem Harris
    Westchester Medical Center, Section of Interventional Pulmonology, United States


A 43-year old man presented with recurrent pneumonias, episodes of hemoptysis and an enlarging right lower lobe mass. A clear diagnosis was not previously established in spite of multiple radiological evaluations and biopsies. Meticulous review of his CT imaging showed that he had subcarinal calcification on his prior CT scans, which had decreased in size and now multiple new small areas of calcifications were seen in the right lower lobe lesion. An esophago-pulmonary fistula due to migration of mediastinal calcifications was suspected which was identified on careful review of the CT chest and confirmed by esophagogastroduodenoscopy. Patient had surgical repair with complete recovery.


Esophago-pulmonary fistula; broncholith; mediastinal calcification; pneumonia; hemoptysis.

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Submitted: 2017-01-28 04:11:48
Published: 2017-05-18 10:47:01
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Copyright (c) 2017 Jadd Kebbe, Sai Yendamuri, Charles Roche, Kassem Harris, Samjot Singh Dhillon

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