Abstract
A bronchofiberoptic examination was performed to a 63-year old woman with collapsed right middle lobe on chest X-ray films. The endoscopic finding of the right middle lobe bronchus showed a flattened deformity of orifice, a low polypoid elevation on the lateral wall, thickening and redness of mucosa. For differential diagnosis of the polypoid lesion transbronchial needle aspiration (23 G 4 mm-length needle for endoscopy) was performed, but just after pulling out needle from polypoid lesion spouting bleeding came out vigorously. Fortunately the bleeding stopped spontaneously in several minutes at that time, but massive bleeding recured 3 days later and the patient was saved by emergency resection of right middle lobe. According to anatomical appearance at operation and pathohistological findings of resected material, we presumed that the bleeding had occured accidentally because the needle had penetrated through weakened site of bronchial wall and then punctured a dilated bronchial artery running along with bronchus.
