The Indian Journal of Tuberculosis - LRS Institute of Tuberculosis ...

Original Article Ind. J. Tub., 1992, 39, 33
FIBREOPTIC BRONCHOSCOPY IN PATIENTS HAVING
IDIOPATHIC HAEMOPTYSIS
B.K Khanna and S.K. Sharma
(Received on 18.9.90; Accepted on 30.8.91)
Then, fibreoptic bronchoscopy was done in
each case under local anaesthesia. Bronchial
biopsy was done in those patients having visible
growth. In all the cases, bronchial aspirate was
collected under aseptic conditions and sent for
microbiological and pathological examination.
Introduction
Haemoptysis is a common symptom in
diseases of respiratory system. It is all the more
common in this country where tuberculosis is still
rampant. The aetiological diagnosis can be
established in not more 66% of the cases with
non-invasive techniques 1 The problem, indeed,
becomes challenging when this symptom occurs
in an asymptomatic case presenting with a
'normal' chest X-ray (“idiopathic” haemoptysis).
In our department, we have performed
fibreoptic bronchoscopy (bronchial aspirate and
bronchial biopsy, where indicated) in 28 such
cases. The analysis of the findings in these cases is
presented.
Material and Methods
In all 28 cases with a 'normal' chest X-ray and
history of having had haemoptysis (moderate
degree : more than 10 ml. but less than 100 ml)
were admitted to Kasturba TB Hospital for
investigation during the calender years 1987-1989.
Of these, 20 cases were male and 8 female; their
mean age was 26.2 years and history of previous
respiratory and or cardiac illness was absent.
None were smokers or ex-smokers.
Repeat chest X-ray (P.A. and the relevant
lateral view) was taken in each case and labelled
as normal only when two physicians of the
department concurred.
Results
The final diagnosis arising out of fibreoptic
bronchoscopy is shown below :
Total cases examined Tracheo-bronchitis
Pulmonary tuberculosis Bronchogenic
carcinoma (adeno-carcinoma) No finding
Discussion
28
6
Fibreoptic bronchoscopy is a valuable
diagnostic tool and its indications are well
defined 1 Haemoptysis of unknown origin is a
recognised clinical entity despite repeated efforts
at establishing the aetiology of haemoptysis,
which do not succeed beyond 33% 2 - The diseases
commonly responsible for idiopathic haemoptysis
include bronchogenic carcinoma, chronic
bronchitis, pulmonary tuberculosis and
endobronchial granuloma. In Jackson's series of
48 cases 2 ' only in 4 cases could the cause of
haemoptysis be established by fibreoptic
bronchoscopy. The frequency and nature of
diseases underlying idiopathic haemoptysis vary
with age of the patient, amount of apparent
haemoptysis and prevalence of various
respiratory diseases in that country. However, we
2
1
Department of Tuberculosis & Respiratory Diseases, K.G.'s Medical College, Lucknow.
Correspondence : Dr. B.K. Khanna, Professor and Head of Department of TB and Resspiratory Diseases, K.G.'s
Medical. College, Lucknow-226 003.