Massive Hemoptysis in Bronchial Dieulafoy’s Disease: Suspect Early

Bronchial Dieulafoy's disease (BDD) is a rare vascular anomaly in which an enlarged, dysplastic submucosal bronchial artery can rupture through focally attenuated or even intact epithelium, causing lifethreatening hemoptysis.A 65-year-old lifelong nonsmoking female presented with massive hemoptysis.Bronchoscopy revealed a 5-mm pulsatile polyp in the basal segment of the left lower lobe; a bronchoscopic biopsy precipitated torrential bleeding that was temporarily controlled with vasoconstrictors.Selective arteriography demonstrated a tortuous bronchial artery with a 5-mm saccular ectasia and rapid arteriovenous shunting.Super-selective embolization achieved immediate homeostasis; however, a durable cure required subsequent lobectomy.BDD should be considered in cases presenting with cryptogenic massive hemoptysis.Endobronchial biopsy is contraindicated, and treatment requires either embolization or surgery.