silicotuberculosis with esophagobronchial fistula and broncholithiasis

a 69-year-old woman was admitted to hospital 4 times from november 2007 to june 2009. the patient had silicosis complicated by broncholithiasis, esophagobronchial fistula, and relapsed tuberculosis. she had worked as a stone crusher for 3 years and was exposed to a large amount of quartz dust. barium esophagography, gastroesophageal endoscopy, and biopsy suggested esophageal-related chronic inflammation and ulcer, which probably caused the repeated esophagobronchial fistulas observed. bronchoscopy revealed a free broncholithiasis in the left main bronchus. the patient was readmitted a fourth time, for the relapse of silicotuberculosis. after 9 months of antituberculous therapy, she was doing well until the recent last follow-up visit.