Bronchoscopy in patients with haemoptysis and normal chest roentgenograms

doi:10.1016/0007-0971(87)90138-0

British Journal of Diseases of the Chest

Volume 81, 1987, Pages 186-188

https://doi.org/10.1016/0007-0971(87)90138-0 Get rights and content

Abstract

We reviewed the records of 58 patients with haemoptysis and normal chest roentgenograms who underwent fibreoptic bronchoscopy. A diagnosis of malignancy was made in six patients at bronchoscopy. Three patients had bronchogenic squamous cell carcinoma, one a carcinoid tumour and two laryngeal carcinoma. Sputum for cytology was negative for malignant cells in all six patients. Follow-up data were available for the other 52 patients for an average period of 55.7±29.6 (sd) months. Two patients had a subsequent diagnosis of bronchogenic carcinoma at 2 and 6 years after initial evaluation. Three patients died from conditions not related to pulmonary malignancy and the remaining patients followed a benign course. Our patients come from a predominately male, elderly population of cigarette smokers. Among such patients, we conclude that bronchoscopy is indicated in the evaluation of those with haemoptysis and a normal chest roentgenogram.

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Role of fiberoptic bronchoscopy in patients with hemoptysis and a normal chest roentgenogram
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Cited by (12)

Imaging Characteristics of Lung Cancer
2011, Seminars in Roentgenology
Citation Excerpt :
Some of the earliest signs of squamous cell carcinoma both clinically and radiologically occur because of its origin from the bronchial epithelium and growth into the bronchus. Bronchial invasion and occlusion can lead to both postobstructive lung collapse and hemoptysis.24-26 It is often these secondary signs and symptoms of central squamous cell carcinoma that lead to an initial diagnosis because many smaller tumors can be missed on radiograph as the result of overlying hilar and mediastinal structures.27,28
Imaging techniques in the evaluation of tracheobronchial neoplasms
1991, Chest
Bronchoscopy for hemoptysis (I)
1990, Chest
Bronchoscopy to evaluate hemoptysis in older men with nonsuspicious chest roentgenograms
1989, Chest
Six of 106 older men with hemoptysis and a nonsuspicious chest roentgenogram who underwent fiberoptic bronchoscopy were found to have cancer. Four of the five bronchogenic carcinomas appeared to be surgically resectable. Cancer patients were significantly older, had smoked within the last five years, and had a significantly higher frequency of central abnormalities on chest roentgenogram. Six additional bronchogenic carcinomas were diagnosed at follow-up. Two of these were probably present but not detected at the time of bronchoscopy. We conclude that (1) hemoptysis with a nonsuspicious chest roentgenogram carries an appreciable risk of cancer in older men with substantial smoking histories, (2) these cancers are often resectable, (3) a chest roentgenogram in which the central lung fields are obscured in any way should not be considered negative in patients with hemoptysis, and (4) a negative bronchoscopic examination does not exclude the possibility of cancer in these patients.
Is investigation of patients with haemoptysis and normal chest radiograph justified?
2011, Thorax
Is investigation of patients with haemoptysis and normal chest radiograph justified?
2009, Thorax
Haemoptysis is a common clinical symptom. A small proportion of patients present with haemoptysis and normal chest radiograph. The investigation strategy for this group of patients is unclear. The aim of this study is to see whether further investigations for this group of patients are justified.
A retrospective analysis was conducted of consecutive patients presenting with haemoptysis and normal chest radiograph over a period of 56 months irrespective of their smoking status. These patients were investigated by CT of the thorax and fibreoptic bronchoscopy.
275 episodes of haemoptysis with normal chest radiograph were investigated further in 270 patients (60% males). The median age was 60 years. Twenty-six patients were diagnosed to have respiratory tract malignancies (larynx, 1; trachea, 1; lung, 22; carcinoid, 1; and leiomyoma, 1). Eight (31%) of the 26 patients with respiratory tract malignancy had radical treatment. Fibreoptic bronchoscopy was diagnostic of cancer in 14 (54%) of the 26 patients with malignancy. CT of the thorax was suggestive of cancer in 24 (96%) of the 25 patients with malignancy.
It is concluded that further investigation of haemoptysis in smokers is justified regardless of the amount or frequency of haemoptysis based on a 9.6% rate of malignancy in this consecutive series. It is recommended that these patients are investigated with CT of the thorax followed by fibreoptic bronchoscopy.

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Original articleBronchoscopy in patients with haemoptysis and normal chest roentgenograms

Abstract

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Original article
Bronchoscopy in patients with haemoptysis and normal chest roentgenograms