title: Massive cryptogenic hemoptysis undergoing pulmonary resection: clinical and pathological characteristics and management.
abstract: Massive cryptogenic hemoptysis is a common presenting symptom and cause of hospitalization for respiratory diseases, and represents a challenging condition in the clinical. This study aimed to analyze the clinical and pathologic data and management of patients with massive cryptogenic hemoptysis. We retrospectively reviewed 12 patients with massive cryptogenic hemotysis in our hospital between January 2003 and December 2012. Bronchoscopy showed submucosal vascular abnormalities in 4 patients. Of 6 patients managed with conservative measures, bleeding was completely controlled in 2 patients. Of 10 hemoptysis patients, three were controlled by bronchial arterial embolization, and seven by surgery. Pathological examination showed a superficial dysplastic, tortuous and dilated bronchial artery under the bronchial epithelium in 4 patients, and bronchiole dilation in 2 patients, indicating Dieulafoy's disease of the bronchus and bronchiectasis. No malignance developed within the follow-up. In conclusion, Dieulafoy's disease of the bronchus and bronchiectasis should be suspected in patients with massive cryptogenic hemoptysis. BAE and surgical treatment should be considered in case that massive hemoptysis could not be controlled by conservative management.
authors.affiliation: Department of Respiratory Medicine, The Second Affiliated Hospital, Wenzhou Medical University Wenzhou 325027, Zhejiang, China.
authors.forename: Xiao-Dong
authors.initials: XD
authors.lastname: Xia
authors.affiliation: Department of Respiratory Medicine, The Second Affiliated Hospital, Wenzhou Medical University Wenzhou 325027, Zhejiang, China.
authors.forename: Le-Ping
authors.initials: LP
authors.lastname: Ye
authors.affiliation: Department of Respiratory Medicine, The Second Affiliated Hospital, Wenzhou Medical University Wenzhou 325027, Zhejiang, China.
authors.forename: Wei-Xi
authors.initials: WX
authors.lastname: Zhang
authors.affiliation: Department of Respiratory Medicine, The Second Affiliated Hospital, Wenzhou Medical University Wenzhou 325027, Zhejiang, China.
authors.forename: Cheng-Yun
authors.initials: CY
authors.lastname: Wu
authors.affiliation: Department of Respiratory Medicine, The Second Affiliated Hospital, Wenzhou Medical University Wenzhou 325027, Zhejiang, China.
authors.forename: Sun-Shun
authors.initials: SS
authors.lastname: Yan
authors.affiliation: Department of Respiratory Medicine, The Second Affiliated Hospital, Wenzhou Medical University Wenzhou 325027, Zhejiang, China.
authors.forename: Hai-Xia
authors.initials: HX
authors.lastname: Weng
authors.affiliation: Department of Respiratory Medicine, The Second Affiliated Hospital, Wenzhou Medical University Wenzhou 325027, Zhejiang, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Lin
authors.affiliation: Department of Respiratory Medicine, The Second Affiliated Hospital, Wenzhou Medical University Wenzhou 325027, Zhejiang, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Xu
authors.affiliation: Department of Thoracic Surgery, The Second Affiliated Hospital, Wenzhou Medical University Wenzhou 325027, Zhejiang, China.
authors.forename: Yue-Feng
authors.initials: YF
authors.lastname: Zhang
authors.affiliation: Department of Respiratory Medicine, The Second Affiliated Hospital, Wenzhou Medical University Wenzhou 325027, Zhejiang, China.
authors.forename: Yuan-Rong
authors.initials: YR
authors.lastname: Dai
authors.affiliation: Department of Respiratory Medicine, Qilu Hospital, Shandong University Jinan, 250021, Shandong, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Dong
keywords: Cryptogenic hemoptysis; Dieulafoy’s disease; bronchus; outcome