Internal Medicine Flashcard|Articles in Press

A typical but rare cause of hemoptysis

Published:March 12, 2023DOI:
      A 51-year-old female patient was admitted to our institution because of abnormal lung shadows that were accidentally found during her health examination. The patient did not experience fever, cough, and sputum. She attained menarche at 15 years with a regular cycle of 5–6/28. At the age of 36, she underwent hysterectomy because of hysteromyoma and recovered well, but hemoptysis (∼10 mL) occurred 1 month after the operation, which disappeared after 3 days. Hemoptysis then occurred regularly every month with a frequency of 3–4 days. The onset was accompanied by lower abdominal distension and lumbosacral discomfort. The patient went to the gynecological clinic for re-examination several times, and no abnormality was found. At the age of 48, hemoptysis and other accompanying symptoms disappeared. No other significant findings were obtained from physical examination and laboratory investigations. Chest CT scan showed an ill-defined ground-glass opacity with small cystic change in the right middle lobe of the lung (Fig. 1A) and a ground-glass attenuation with a nodule in the right lower lung (Fig. 1B∼C). What is your diagnosis?
      Fig 1
      Fig. 1Imge of Chest CT. (A) Area of ill-defined ground-glass opacity with small cystic changes (Dovetail arrow) in the right middle lobe of the lung. (B) Ground-glass attenuation with a nodule (arrows) in the right lower lobe of the lung. (C) Oblique sagittal reconstruction image of right lower lobe lesions. Bronchus is seen in the lesion, and the nodule(arrows) is located at the distal end of the bronchus.


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