Tuberc Respir Dis > Volume 42(1); 1995 > Article
Tuberculosis and Respiratory Diseases 1995;42(1):42-49.
DOI: https://doi.org/10.4046/trd.1995.42.1.42    Published online February 1, 1995.
Evaluation of Patients with Hemoptysis and A Normal Chest Roentgenogram.
Chun Duk Han, Yeon Jae Kim, Yeung Suk Lee, Jae Yong Park, Tae Hoon Jung
Department of Internal Medicine, School of Medicine, Kyungpook National University, Taegu, Korea.
Abstract
BACKGROUND
Hemoptysis always merits thorough investigation because even minimal bleeding may be an early indicator of the presence of significant bronchopulmonary disease. But in patients with hemoptysis & a normal chest roentgenogram, there are no clear guidelines for a diagnostic approach, including the indications of bronchoscopy. METHODS: Eighty patients with hemoptysis and a normal chest roentgenogram were involved in this study. We evaluated the cause of hemoptysis in these patients by bronchoscopy and/or bron- chogram or high-resolution CT of the lung and we analyzed the relationship of clinical features, such as age, sex, smoking and properties of hemoptysis, to the cause of hemoptysis. RESULTS: 1) They were 34 men and 46 women, with the mean age of 46.7 and 41.8 years old, respectively. 2) Initial bronchoscopy provided a diagnosis in 8 patients - bronchogenic carcinoma in 3 patients (3.8%), metastatic cancer in 1 patient(1.3%) and endobronchial tuberculosis in 4 patients(5.0%). 3) Two clinical findings of patients over 50 years and/or with more than 30 pack-year smoking history were associated with bronchogenic carcinoma, and among these two factors, a more than 30 pack-year smoking history was the best predictor for diagnosis of bronchogenic cancer. 4) The 72 patients in whom no specific cause of hemoptysis was identified by initial bronchoscopy underwent bronchogram and/or high resolutional CT of the lung. Then, 6 patients were diagnosed as bronchiectasis and 5 patients rebleeded in the follow up period of 9 to 90 weeks. Of the remaining 66 patients, 33 were followed for 7 to 80 weeks. Among these patients, only 5 patients had recurrent episodes of hemoptysis &A they were diagnosed as bronchiectasis in 1 patient, tuberculosis in 2 patients and catamenial hemoptysis in 2 patients. CONCLUSION: We conclude that patients with hemoptysis and a normal chest roentgenogram who are more than 50 years old or have more than 30 pack-year smoking history should undergo bronchoscopy to exclude possible bronchogenic carcinoma. In patients without these clinical features, a conservative approach with observation appears justified. If hemoptysis recurs to these patients, bronchogram or high-resolutional CT of the lung with sputum examination are necessary.
Key Words: Hemoptysis, Normal chest roentgenogram


ABOUT
ARTICLE & TOPICS
Article category

Browse all articles >

Topics

Browse all articles >

BROWSE ARTICLES
FOR CONTRIBUTORS
Editorial Office
101-605, 58, Banpo-daero, Seocho-gu (Seocho-dong, Seocho Art-Xi), Seoul 06652, Korea
Tel: +82-2-575-3825, +82-2-576-5347    Fax: +82-2-572-6683    E-mail: katrdsubmit@lungkorea.org                

Copyright © 2024 by The Korean Academy of Tuberculosis and Respiratory Diseases. All rights reserved.

Developed in M2PI

Close layer
prev next