Life-threatening pulmonary hemorrhage is a rare complication of endobronchial biopsies that is known to occur after biopsies of vascular neoplasms are performed or in patients with coagulation disorders. We report a patient with right middle lobe atelectasis in whom neither neoplasm nor coagulopathy was present who had a fatal outcome from massive hemorrhage after routine biopsy of a deformity of the right middle lobe orifice. The overlying mucosal tissue was normal without endoscopically visible vessels. Pathology from the biopsy specimen showed an unexpected submucosal bronchial artery. Bronchoscopists are cautioned to consider aberrant bronchial vessels before acquiring biopsy specimens from endobronchial abnormalities without obvious neoplastic involvement of the mucosa and when encountering unexpected prolonged hemorrhage after biopsy.
Journal of Bronchology7:233-235, 2000.
PT, prothrombin time; PTT, partial thromboplastin time
*Thomas Jefferson University School of Medicine, †Our Lady of Lourdes Medical Center, ‡University of Medicine and Dentistry of New Jersey School of Osteopathic Medicine, Camden, New Jersey, U.S.A.
Address reprint requests to Dr. Alan R. Pope, Department of Medicine, Our Lady of Lourdes Medical Center, 1600 Haddon Avenue, Camden, NJ 08103.
© 2000 Lippincott Williams & Wilkins, Inc.