Abstract
Bronchoscopic findings of bronchial mucosal protuberances in three patients with bronchial arterial dilatation demonstrated by angiography were reported. An unexpected massive bleeding was seen after biopsy the mucosal protuberance in the first patient. Microscopic examination of the biopsy specimen revealed that it contained a piece of arterial wall. Owing to this experience, massive bleeding due to biopsy could be avoided in the following two patients. The endoscopical fingings of the mucosal protuberance caused by bronchial arterial dilatation were characterized by localization in the middle lobe bronchus in three cases and also the upper lobe bronchus in one. In addition the mucosal protuberance had a hemispherical shape with smooth tensioned surface consisting of normal mucosa. Some showed slightly elongated shape along the longitudinal axis of the bronchus and some showed elastic caving by compression with the tip of the forceps. Pulsation could be observed in some case by careful observation. It is extremely dangerous to make a bronchoscopical punch biopsy from the protuberances caused by submucosal vessels, especially bronchial arterial dilatation. Therefore, biopsy from any mucosal protuberance should be avoided, if there is a possibility of this kind of disorder.
