Pulmonary hemorrhage may arise from a focal lesion, which typically results in localized hemorrhage.
Causes of localized pulmonary hemorrhage:
(1) chronic bronchitis
(2) bronchiectasis
(3) pneumonia (bacterial, mycobacterial, deep fungal)
(4) lung tumors
(5) blunt or penetrating trauma
Imaging studies may show:
(1) an area of consolidation, which may be lobular or lobar
(2) a cavitary lesion
(3) a mass lesion
(4) an area of atelectasis
(5) no definite change
Imaging studies such as CT and bronchoscopy often are used together to localize and diagnose the lesion. Bronchoscopy is useful for pneumonias and lesions located near the major bronchi. Lung biopsy may be necessary for the diagnosis of peripheral lesions.
Hemorrhage from a localized lesion can be severe, especially in a patient with a coagulopathy. If this blood is aspirated then the picture may mimic diffuse pulmonary hemorrhage.
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