Pulmonary hemorrhage in a hemophiliac simulating a lung neoplasm.
We report an elderly, male smoker with moderate hemophilia B who presented with hemoptysis. Chest imaging revealed a well-circumscribed, pulmonary, mass lesion. Repeated bronchoscopy failed to make a diagnosis, and the patient ultimately underwent open thoracotomy with resection of the mass. Pathologic examination revealed hemorrhagic changes in association with bullous lung disease. This is the first report of symptomatic pulmonary hemorrhage in a patient with hemophilia B. Hemorrhage into a pre-existing bulla can simulate a primary lung neoplasm.
O'Dwyer
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Department of Medicine, Division of Hematology and Medical Oncology, Oregon Health Sciences University, Portland, Oregon 97201, USA. odwyerm@ohsu.edu
DeLoughery
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D000368:Aged; D003937:Diagnosis, Differential; D002836:Hemophilia B / Q000175:diagnosis* / Q000503:physiopathology*; D006470:Hemorrhage / Q000503:physiopathology*; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000503:physiopathology; D008297:Male