Hemoptysis: CT-bronchoscopic correlations in 58 cases.

Abstract

Computed tomographic (CT) and chest radiographic findings were retrospectively correlated with those found at fiberoptic bronchoscopy (FOB) in 58 patients presenting with hemoptysis. Abnormalities involving the airways were depicted by CT in a total of 28 cases (48%). In 18 of these (31% of the total group of 58), focal abnormalities involving the central airways were identified (17 were subsequently proved to be malignant) and in 10 (17% of the total), CT showed bronchiectasis. Focal airway abnormality was shown by FOB in 18 cases (31%); all of these were depicted with CT. Malignancy was diagnosed in 24 patients, including three in whom results of FOB were normal but malignant cells were identified at transbronchial biopsy. CT abnormalities were identified in all cases of malignancy. In 10 of 21 cases (48%) of non-small cell lung cancer, CT allowed definitive staging by documenting either direct mediastinal invasion and/or metastatic disease, while FOB allowed definitive staging in only three cases. CT studies provided no false-negative results. It is concluded that when carefully performed, CT may be an effective modality for evaluating patients presenting with hemoptysis.

Diagnosis and management of hemoptysis

“…Diagnostic modalities for studying hemoptysis include chest radiography (CXR), bronchoscopy, MDCT, MDCT angiography (MDCTA) and digital subtraction angiography (DSA) (4,5,(25)(26)(27).…”

“…Bronchoscopy has an overall lower sensitivity than MDCT in detecting the underlying causes of bleeding (8,(25)(26)(27)29). In a study by Revel et al (29), the cause of bleeding was identified in 8% of the patients, with bronchoscopy and in 77%, with MDCT.…”

“…MDCT also has the advantage of showing distal airways beyond the level of the bronchoscope (25,26,28,33), and it has a sensitivity of more than 90% in identifying endobronchial lesions (10).…”

Complications Leading to Sudden Cardiac Death in Pulmonary Arterial Hypertension

“…[100][101][102] Routine chest x-ray is readily available and helpful; however, in a retrospective evaluation of 208 patients with hemoptysis, Hirshberg et al 103 found that radiography was diagnostic in only 50% of cases. Bronchoscopy is by far more accurate, but the role of fiberoptic bronchoscopy in the setting of massive active hemoptysis is still controversial.…”

A Prospective Evaluation of Hemoptysis Cases in a Tertiary Referral Hospital

“…Although exact percentages vary in large general populations, bronchiectasis, tuberculosis, and bronchogenic carcinoma are the leading causes of hemoptysis (3,4,5,) . A major problem in haemoptysis is the wide spectrum of etiologies that may result in haemoptysis ( 6,7,8) and variations in the reported prevalence. The effective management of haemoptysis depends upon identification of the etiology and localization of the site of bleeding.…”