Lewis J. Wesselius, MD
Department of Pulmonary Medicine
Mayo Clinic Arizona
Scottsdale, AZ
History of Present Illness
A 39 year old woman is seen with a history of cough intermittently productive of small amounts of blood or blood-tinged sputum for 4 months. She reports no other respiratory symptoms and has otherwise felt well.
PMH, FH and SH
There was no significant PMH and no prior history of lung disease. Her father has a history of Parkinson’s disease and osteosarcoma. She is a nonsmoker, does not drink alcohol, and has never abused drugs. She has 2 children and is engaged to be remarried.
Physical Examination
Her physical examination is normal.
Chest X-ray
Her chest x-ray is below (Figure 1).
Figure 1. Panel A: Frontal chest radiography. Panel B: Lateral chest radiography.
Laboratory Evaluation
Hemoglobin was 13.2 g/dL and WBC was 8400 cells/μL with a normal differential. Urinanalysis was unremarkable.
Which of the following statements regarding hemoptysis is or are true?
- A normal chest x-ray makes a benign cause of the hemoptysis more likely
- Most patients with lung cancer are asymptomatic
- Hemoptysis in children is usually associated with an infection or a foreign body
- 1 + 3
- All of the above
Reference as: Wesselius LJ. October 2012 pulmonary case of the month: hempotypsis from an uncommon cause. Southwest J Pulm Crit Care 2012;5:169-75. PDF