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Lung diseases

Coughing up small white pebbles.

01/24/2008

Question:

Hi, I`m a 21 year old female and for about 2-3 years I have randomnly had a bad cough which I would feel something that has developed in my throat. I cough hard enough to the point to where I would cough up small ivory colored pebbles. They are hard yet alittle tender to touch and come in various sizes but recently have consistently been the size of a pea or less. I`m completely healthy or so I believe to be. What could it be? I have no history of smoking or anything lung related. It appears to be calcium buildup. I assumed gallstones but I could be wrong.

Answer:

It sounds like you are describing lithoptysis (the medical term for coughing up stones). A fairly uncommon complaint, the presence of lithoptysis may suggest a condition called broncholithiasis, where calcified material from within the chest erodes into the airways where it can be coughed up. Chronic inflammation in response to a healing infection such as pneumonia, fungal, or TB (which is uncommon in the US, but much more common in developing countries) can cause calcification of the lymph nodes in the chest near the trachea and or airways which can then erode through the walls of the airways, allowing small pieces or stones to be coughed up. In rare cases, larger pieces of calcium can cause partial or complete obstruction of an airway, increasing a patient's risk of developing an infection behind the obstruction.

Although this problem has been going on for several years, I would recommend that you see a pulmonologist to evaluate the many possible causes.

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Response by:

Jennifer  McCallister, MD Jennifer McCallister, MD
Clinical Assistant Professor of Pulmonary, Allergy, Critical Care & Sleep
College of Medicine
The Ohio State University