An 86-year-old woman presented to the pulmonology department following a 4-month history of a progressive nonproductive cough, wheezing, and exertional dyspnea. A plain-film chest radiograph demonstrated a foreign body in the lower lobe of her right lung (image A). Symptoms began 1 week after a tooth extraction, during which a gold crown on an adjacent tooth was dislodged and presumably ingested. Chest computed tomography confirmed a foreign body in the basal segment of the right lower lobe. Subsequent flexible bronchoscopy revealed a metallic-appearing object in the right bronchus intermedius (image B), which was successfully extracted via bronchoscopy using a basket instrument for renal stones. 

Tracheobronchial foreign body aspiration is a rare occurrence among adults.^1,2 Clinical manifestations of distal airway obstruction include chronic cough, fever, hemoptysis, chest pain, and wheezing, which can be further complicated by postobstructive pneumonia and atelectasis.^1,3 Flexible bronchoscopy serves as a diagnostic and therapeutic modality in the management of lower airway obstruction.^1,4