• Lung Cancer
• Imaging/CT MRI etc

A 90-year-old man visited our hospital with a chief problem of haemoptysis lasting for a month. He had a medical history of bladder cancer, including transurethral resection, 10 years previously. Chest and abdominal CT demonstrated a large cystic lesion with thin walls surrounded by infiltration and ground-glass opacities in the left lower lobe of the lung (figure 1A), with no findings of bladder cancer recurrence. Bronchoscopy detected a small amount of blood adhered to the lower left bronchus. Bronchial lavage fluid cultures did not identify bacterial, mycobacterial or fungal infections, and serological testing was negative for Aspergillus antigen. Subsequent bronchial artery embolisation failed to achieve haemostasis. Because the volume of haemoptysis was low, and the patient refused surgical resection of the cystic lesion to control the bleeding, careful observation was undertaken. Tranexamic acid was administered orally from the initial visit, and the haemoglobin level gradually decreased. Four intermittent blood transfusions were performed when the haemoglobin level dropped below 7.5 g/dL. Three months post initial visit, chest CT demonstrated a slight exacerbation of the infiltration around the cyst in the left lower lobe, with no findings of new cysts nor nodules in the lung fields. Subsequent periodic CT …