Q: 58 year old male with a history of HIV is admitted to ICU with hemoptysis. There is a concern for Kaposi sarcoma. Which study would be appropriate to demonstrate it? (select one)
A) Flexible bronchoscopy
B) High-resolution CT (HRCT)
Answer: A
There is a misconception that HRCT can see everything. Bronchoscopy and CT scan both complement each other. CT scans can demonstrate bronchiectasis, aspergillomas, and carcinomas better. On the other hand, bronchoscopy is ideal for subtle mucosal abnormalities such as bronchitis, papillomas, Dieulafoy disease, bronchial carcinoid, and Kaposi sarcoma.
In the case of active hemoptysis, flexible bronchoscopy would be preferred to visualize active bleeding.
#pulmonary
References:
1.
Set PA, Flower CD, Smith IE, et al. Hemoptysis: comparative study of the role of CT and fiberoptic bronchoscopy. Radiology 1993; 189:677.
2. McGuinness G, Beacher JR, Harkin TJ, et al. Hemoptysis: prospective high-resolution CT/bronchoscopic correlation. Chest 1994; 105:1155.
3. Tak S, Ahluwalia G, Sharma SK, et al. Haemoptysis in patients with a normal chest radiograph: bronchoscopy-CT correlation. Australas Radiol 1999; 43:451.
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