case_images: PMC9193580_01
case_images: A simple chest photograph at the time of emergency transport showed reticular shadows in the bilateral lower lung fields (upper left panel). Computed tomography (CT) at the time of emergency transport showed an infiltrative shadow with air bronchograms in the right lower lobe. There were emphysematous changes in the bilateral lungs (lower right panel). CT performed 106 days after initial discharge showed that the infiltrative shadow in the right lower lobe had disappeared (lower panel).
case_images: fmed-09-875311-g0001.jpg
case_images: PMC9193580_01_fmed-09-875311-g0001.jpg
case_images: F1
case_images: A chest radiograph on admission demonstrated reticular shadows in the right lower lung fields (Figure 1, upper left panel). The left lower lobe showed ground-glass opacity and fibrotic and cystic changes (Figure 1, upper right panel). On follow-up chest imaging, the lower lobe infiltrates had resolved with residual underlying fibrotic changes that are currently being evaluated for suspected smoking-related interstitial lung disease (Figure 1, lower panel).
case_images: Bronchoscopy performed on the day of admission showed a polypoid elevated lesion at the bifurcation of the left upper lobe (upper left panel). Passage of bronchoscope revealed pulsatile bleeding around the polypoid lesion (upper right panel). Bronchoscopy performed 106 days after the initial hospitalization revealed that the elevated lesion completely disappeared (lower panel).
case_images: fmed-09-875311-g0002.jpg
case_images: PMC9193580_01_fmed-09-875311-g0002.jpg
case_images: F2
case_images: As the results, a polypoidal elevated lesion was observed in the left upper lobe bifurcation (Figure 2, upper left panel). There were no exposed blood vessels in the tracheal lumen, but passage of the bronchoscope revealed pulsatile bleeding from the periportal area of the polyp (Figure 2, upper right panel). As the results, the bronchial inflammatory polyp completely disappeared although this polyp previously caused massive hemoptysis and repeated bloody sputum in this subject (Figure 2, lower panel).
case_images: Findings in biopsy specimen from the hemorrhagic polypoid lesion. The upper panel shows a weakly magnified image of HE staining, and the lower panel shows a strongly magnified image of HE staining. Foci of reactive myofibroblast proliferation were observed from the bronchial mucosa to the bronchial lumen.
case_images: fmed-09-875311-g0003.jpg
case_images: PMC9193580_01_fmed-09-875311-g0003.jpg
case_images: F3
case_images: Histopathology demonstrated a foci of reactive myofibroblast growth from the bronchial mucosa to the endobronchial palace suggestive of a bronchial inflammatory polyp (Figure 3).