title: Hemoptysis:  a serendipitous discovery.
abstract: The etiology of hemoptysis can sometimes be difficult to identify and requires a complete and sequential approach. It is also important to initially maintain a broad differential diagnosis. We present a patient who had an extremely rare adenoid cystic carcinoma of the nasopharynx as the cause of hemoptysis. This also highlights the importance of having a uniformly systematic approach to bronchoscopic inspection, with careful attention to areas beyond the actual tracheobronchial tree. Often, the nasopharyngeal and oropharyngeal regions are not as meticulously inspected during bronchoscopy. The fact that careful attention to both nares by bronchoscopic inspection aided the final diagnosis suggests that a thorough examination to these often overlooked areas should be routine.
authors.affiliation: *Division of Pulmonary & Critical Care and Sleep Medicine, Tufts Medical Center, Boston †Department of Otolaryngology & Head and Neck Surgery, Lahey Clinic Medical Center, Burlington ‡Department of Pulmonary and Critical Care, Lahey Clinic Medical Center, Burlington, MA.
authors.forename: Maher
authors.initials: M
authors.lastname: Tabba
authors.forename: Timothy
authors.initials: T
authors.lastname: Anderson
authors.forename: Carla
authors.initials: C
authors.lastname: Lamb