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[Timely bronchoscopic examination for a patient with hemoptysis].

A 61-year-old man was referred to our hospital due to hemoptysis. The patient told us that the amount of it needed two pieces of towels to wipe it off. It began a few days ago and continued intermittently. The patient had no medical history of respiratory disease and did not have any anticoagulants. He smoked 30-pack-year. Ground glass opacity was observed in both lungs, but it seemed to be slightly left-sided predominance (Figure 1). By one-day hospitalized observation, we confirmed continuation of intermittent bloody sputum, but not massive hemoptysis. To clarify the bronchus that the bleeding was related to, we performed an examination by fiberoptic bronchoscopy and confirmed active bleeding from left upper lobe bronchus (Figure 2). As arterio-venous malformation was highly suspected, the patient was transferred to another hospital to receive an embolic therapy. But angiographyic examination showed afocal inflammatory change in left upper lobe was the responsibility lesion of the bleeding.