Indications for Fiberoptic Bronchoscopy in Patients with Hemoptysis

Abstract

We reviewed the medical records of 135 patients with hemoptysis to investigate the indications for fiberoptic bronchoscopy. There were 48 patients with findings related to hemoptysis on chest roentgenograms, and 87 patients without any related findings. Lung cancer was diagnosed in 33.3% of the 48 patients with related findings on chest roentgenograms, and 2.3% in the 87 patients without related findings. All 18 patients with lung cancer were males over 40 years old with significant smoking history (≧20 pack-years). Among the 18 cases there were 4 patients with negative sputum cytology. In 2 out of the 18 patients lung cancer was detected only by fiberoptic bronchoscopy. It was not possible to detect all lung cancer by only chest roentgenograms and sputum cytology in patients with hemoptysis. We conclude that the following patients should be examined using fiberoptic bronchoscopy if they complain of hemoptysis ; (1) all patients with abnormal findings on chest roentgenograms and (2) patients over 40 years old with significant smoking history even without abnormal findings on chest roentgenograms.