Clinical outcomes of cystic fibrosis patients with hemoptysis treated with bronchial artery embolization / Desfechos clínicos de pacientes com fibrose cística e hemoptise tratada por meio de embolização arterial brônquica

ABSTRACT Objective: Massive hemoptysis is one of the most serious complications in patients with cystic fibrosis (CF). This study aimed to evaluate the hemoptysis-free period following bronchial and non-bronchial artery embolization (BAE/non-BAE) in CF patients and to investigate predictors of recurrent bleeding and mortality by any cause. Methods: This was a retrospective cohort study of CF patients ≥ 16 years of age undergoing BAE/non-BAE for hemoptysis between 2000 and 2017. Results: We analyzed 39 hemoptysis episodes treated with BAE/non-BAE in 17 CF patients. Hemoptysis recurrence rate was 56.4%. Of the sample as a whole, 3 (17.6%) were hemoptysis-free during the study period, 2 (11.8%) underwent lung transplantation, and 3 (17.6%) died. The median hemoptysis-free period was 17 months. The median hemoptysis-free period was longer in patients with chronic infection with Pseudomonas aeruginosa (31 months; 95% CI: 0.00-68.5) than in those without that type of infection (4 months; 95% CI: 1.8-6.2; p = 0.017). However, this association was considered weak, and its clinical significance was uncertain due to the small number of patients without that infection. Conclusions: BAE appears to be effective in the treatment of hemoptysis in patients with CF.

RESUMO Objetivo: A hemoptise maciça é uma das complicações mais graves em pacientes com fibrose cística (FC). O objetivo deste estudo foi avaliar o período livre de hemoptise após a embolização arterial brônquica/não brônquica (EAB/não EAB) em pacientes com FC e investigar preditores de sangramento recorrente e mortalidade por qualquer causa. Métodos: Trata-se de um estudo retrospectivo de coorte de pacientes com FC com idade ≥ 16 anos submetidos a EAB/não EAB para o tratamento de hemoptise entre 2000 e 2017. Resultados: Foram analisados 39 episódios de hemoptise tratada por meio de EAB/não EAB em 17 pacientes com FC. A taxa de recidiva da hemoptise foi de 56,4%. Do total de pacientes, 3 (17,6%) permaneceram sem hemoptise durante o estudo, 2 (11,8%) foram submetidos a transplante de pulmão e 3 (17,6%) morreram. A mediana do período sem hemoptise foi de 17 meses. A mediana do período sem hemoptise foi maior em pacientes com infecção crônica por Pseudomonas aeruginosa (31 meses; IC95%: 0,00-68,5) do que naqueles sem esse tipo de infecção (4 meses; IC95%: 1,8-6,2; p = 0,017). No entanto, essa associação foi considerada fraca, e sua importância clínica foi considerada incerta em virtude do pequeno número de pacientes sem essa infecção. Conclusões: A EAB parece ser eficaz no tratamento de hemoptise em pacientes com FC.

Tratamiento percutáneo de la hemoptisis. Anatomía, fisiopatología y metodología / Percutaneous treatment of hemoptysis. Anatomy, physiopathology and methodology

Resumen Se presentan los resultados de 105 pacientes con hemoptisis amenazante tratados mediante embolización arterial por cateterismo percutáneo por vía arterial sistémica y/o arterial pulmonar. Se describe la técnica del procedimiento y los hallazgos angiográficos. Se muestra la utilidad de la fibrobroncoscopía y de la radiografía de tórax para identificar la zona sangrante como diagnóstico previo al procedimiento. Entre mayo 2000 y septiembre 2015 se admitieron en el Servicio de Hemodinamia 105 pacientes con diagnóstico de hemoptisis amenazante, 76 masculinos (72.4%); edad media: 41 (±18.65 DS) años. El 93% (98/105) fue tratado con éxito. En el 90% (88/98) se efectuó embolización por arterias bronquiales y/o no bronquiales sistémicas y en el 10% (10/98) por vía arterial pulmonar. Cuando la afección era bilateral la angiografía sola no posibilitó identificar el sitio de sangrado. Al 60% (63/98) se le hizo fibrobroncoscopía flexible y se pudo ubicar el pulmón sangrante en el 84% (56/63). Cuando la afección era unilateral, la radiografía de tórax previa al procedimiento facilitó la ubicación del área de sangrado en el 47%. No se observaron complicaciones graves ni muertes vinculadas al procedimiento. El tratamiento de la hemoptisis masiva por vía percutánea tiene alto porcentaje de éxito primario con muy baja tasa de complicaciones. El tratamiento por vía arterial pulmonar es un abordaje alternativo. La fibrobroncoscopía flexible es un importante complemento en esta entidad.

Abstract We present the results of 105 patients with life-threatening hemoptysis who were treated with the systemic arterial and/or pulmonary artery routes. We also describe the procedure techniques and the angiographic findings. We show the usefulness of the flexible fiberoptic bronchoscopy and chest radiography to identify the bleeding zone previous to the procedure. From May 2000 to September 2015, a total of 105 patients were admitted to the Catheterization Laboratory with a diagnosis of life-threatening hemoptysis; 76 were male (72.4%) and mean age was 41 ± 18.65 years. Treatment was successful in 93% (98/105). In 90% (88/98) the approach was via the bronchial arteries and/or non-bronchial systemic arteries, and in 10% (10/98) the approach was via the pulmonary artery. In bilateral affection angiographic images alone could not identify accurately the site of the lung bleeding. Flexible fibrobronchoscopy was performed in 60% (63/98) and located the bleeding area in 84% (56/63). In unilateral affection, chest radiography previous to the procedure located the bleeding area in 47%. No complications or death were related to the procedure. The treatment of life threatening hemoptysis by a percutaneous way has a high percentage of primary success with a very low incidence of complications. Pulmonary arterial route treatment is an alternative approach. Flexible fibrobronchoscopy is an important complement to this entity.

CD57 (Leu-7, HNK-1) immunoreactivity seen in thin arteries in the human fetal lung / 대한해부학회지

CD57 (synonyms: Leu-7, HNK-1) is a well-known marker of nerve elements including the conductive system of the heart, as well as natural killer cells. In lung specimens from 12 human fetuses at 10–34 weeks of gestation, we have found incidentally that segmental, subsegmental, and more peripheral arteries strongly expressed CD57. Capillaries near developing alveoli were often or sometimes positive. The CD57-positive tissue elements within intrapulmonary arteries seemed to be the endothelium, internal elastic lamina, and smooth muscle layer, which corresponded to tissue positive for a DAKO antibody reactive with smooth muscle actin we used. However, the lobar artery and pulmonary arterial trunk as well as bronchial arteries were negative. Likewise, arteries in and along any abdominal viscera, as well as the heart, thymus, and thyroid, did not express CD57. Thus, the lung-specific CD57 reactivity was not connected with either of an endodermal- or a branchial arch-origin. CD57 antigen is a sugar chain characterized by a sulfated glucuronic acid residue that is likely to exist in some glycosphingolipids. Therefore, a chemical affinity or an interaction might exist between CD57-positive arterioles and glycosphingolipids originating from alveoli, resulting in acceleration of capillary budding to make contact with the alveolar wall. CD57 might therefore be a functional marker of the developing air-blood interface that characterizes the fetal lung at the canalicular stage.

Tricks to do a Quick Successful Bronchial Artery Embolization (BAE) in Massive Haemoptysis

@#Bronchial artery embolization (BAE) is the mainstay treatment for massive haemoptysis. Herein we briefly discuss the tips and tricks of super-selective embolization of bronchial artery using N-butyl-2 cyanoacrylate (NBCA). Based on our experience, this technique produces a better resolution and exhibit high non- recurrence rate in the treatment of massive haemoptysis.

Infección pulmonar por Strongyloides stercoralis en la provincia de Manabí, Ecuador / Lung infection by Strongyloides stercoralis in the province of Manabí, Ecuador

Strongyloides stercoralis es un nematodo común causante de parasitosis intestinal en la población ecuatoriana, pero no se han documentado casos de infección pulmonar por este helminto en el Ecuador. El primer caso de estrongiloidiasis pulmonar causada por larvas filariformes de S. stercoralis en un paciente de sexo masculino de la provincia de Manabí (Ecuador) y con síntomas clínicos de síndrome pulmonar terminal es reportado en este estudio. Previo al deceso del paciente, las larvas fueron identificadas por el método de frotis directo en fresco de una muestra de aspirado bronquial obtenida del paciente. En el análisis microscópico se observó hiperinfección por larvas filariformes (L3) con una abundancia de hasta cuatro larvas por campo microscópico.Sugerimos que un tratamiento anticipado del paciente con un antihelmíntico de amplio espectro podría haberle salvado la vida. La estrongiloidiasis pulmonar puede ser infradiagnosticada, si no se lleva a cabo el análisis parasitológico de muestras húmedas de aspiración bronquial de pacientes mostrando síntomas de bronquitis crónica y síndrome pulmonar para investigar la posible presencia de S. stercoralis. El entrenamiento para diagnóstico microbiológico por métodos directos clásicos, así como la constante investigación de esta parasitosis y otras helmintiasis son aún vitales y relevantes para el personal técnico de salud pública y microbiólogos en países en vías de desarrollo, con el fin de proveer un tratamiento temprano de las parasitosis infradiagnosticadas.

Strongyloides stercoralis is a common nematode causing intestinal parasitosis in the Ecuadorian population, but cases of lung infection by this helminth have not been documented in Ecuador. We document the first case of pulmonary strongyloidiasis caused by S. stercoralis filariform larvae in a male patient from Manabí Province (Ecuador), showing clinical symptoms of terminal pulmonary syndrome. Previous to the decease of the patient, the larvae were identified by the direct smear method of a fresh bronchial aspirate sample collected from the patient. Hyperinfection by filariform larvae (L3) was observed, exhibiting an abundance of up to four larvae per microscopic field. We suggest that an earlier treatment of the patient with a high spectrum anthelmintic could have saved his life. Strongiloidiasis pulmonar can be underdiagnosed, if the parasitological analysis of wet mounts of bronchial aspirate from patients suffering of chronic bronchitis and pulmonary syndrome to investigate the possible presence of S. stercoralis is not conducted. The training for microbiological screening using classic direct methods, as well as the constant investigation of this parasitosis and other helminthiasis are still vital and relevant for public health personnel and microbiologists in developing countries in order to provide an early diagnosis of underdiagnosed parasitosis.

Diffuse alveolar hemorrhage in 4 girls / 中国当代儿科杂志

This article reports 4 girls with clinical manifestations of recurrent cough and anemia. The age of onset was less than 4 years, and three of them had shortness of breath. None of them had acute hemoptysis. All the girls had positive results of hemosiderin test for bronchoalveolar lavage fluid. As for imaging examination, 3 patients had ground-glass opacity, and 1 had interstitial change. Three girls were given the treatment for idiopathic pulmonary hemosiderosis and had no response. Selective bronchial arteriography was performed for the 4 girls and found bronchial artery to pulmonary circulation shunt (BPS). After they were diagnosed with BPS, they were given transcatheter embolization. The girls were followed up for half a year after surgery, and none of them was readmitted due to "cough and anemia". BPS manifests as abnormal shunt between the bronchial artery and the pulmonary artery/vein and has unknown causes. It is rare in children and should be considered for children who were thought to have idiopathic pulmonary hemosiderosis and had poor response to corticosteroid therapy.

Hemoptysis during general anesthesia in a diabetic patient with healed tuberculosis: a case report / 대한마취과학회지

Hemoptysis is a common complication of pulmonary tuberculosis. Most of the cases of hemoptysis originate from hypertrophied bronchial arteries. Also, diabetes induces pulmonary vascular abnormalities such as endothelial dysfunction, inflammatory infiltration and pulmonary vascular remodeling. A 27-year-old male, with diabetes and a history of tuberculosis, underwent the procedure of pars plana vitrectomy under general anesthesia. After an uneventful intra-operative period, he had hemoptysis prior to extubation. Emergency fiberoptic bronchscopy showed blood plugs and spotted fresh blood at the right upper lobar bronchus. After successful embolization of the bronchial artery, the patient made a recovery and was discharged without experiencing any complication. Predisposing factors of hemoptysis in this case are presumed to be tuberculosis and diabetes. The bleeding might had been caused by the rupture of a weakened artery within the cavity in the right upper lobe, through expansion of the lung during manual ventilation by positive pressure.

Surgical Management of a Coronary-Bronchial Artery Fistula Combined with Myocardial Ischemia Revealed by ¹³N-Ammonia Positron Emission Tomography

A 71-year-old male with known bronchiectasis and atrial fibrillation was admitted to Seoul St. Mary's Hospital with recurrent transient ischemic attack. Radiofrequency ablation was performed to resolve the patient's atrial fibrillation, but failed. However, a fistula between the left circumflex artery and the bilateral bronchial arteries was found on computed tomography. Fistula ligation and a left-side maze operation were planned due to his recurrent symptom of dizziness, and these procedures were successfully performed. After the operation, the fistula was completely divided and no recurrence of atrial fibrillation took place. A coronary-bronchial artery fistula is a rare anomaly, and can be safely treated by surgical repair.

Bronchial Artery Aneurysm Presenting Hemoptysis, Initially Mis-diagnosed as Bronchial Arterio-venous Malformation: A Case Report

Normal bronchial arteries are small vessels that arise mostly from the descending thoracic aorta. Bronchial artery aneurysm is defined as a dilatation of the bronchial arteries with a diameter over 2 mm, and is reported in less than 1% of bronchial arterial angiography. A 70-year-old male patient was presented with hemoptysis. He had been treated for pulmonary tuberculosis 50 years ago. He also had a history of admission with hemoptysis 10 years ago, for which he was diagnosed as bronchiectasis on computed tomography imaging. Upon arrival to our hospital, abnormal vascular structure was detected on the mediastinum, arising from the descending thoracic aorta. It was dilated to 14 mm with a saccular form. Initially, we evaluated the structure as a bronchial arteriovenous malformation because it seemed to be drained into the pulmonary vein directly. For further evaluation, he had received a trans-catheter bronchial artery angiography. Both bronchial arteries were hypertrophied, but direct arteriovenous shunt was not detected; as such, we concluded this structure to be bronchial artery aneurysm. We performed embolization for both bronchial arteries and filled the aneurysm with coiling. He had no recurrence of hemoptysis and was discharged on 4 days post embolization. Our case reports an incidental bronchial artery aneurysm, which was initially misdiagnosed as bronchial arteriovenous anomaly, and finally treated with embolization and coiling.

Exploring the effect of embolization of bronchial artery in patients with pneumoconiosis massive hemoptysis / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To explore the effect of embolization of bronchial artery (BAE) in patients with pneumoconiosis massive hemoptysis.</p><p><b>METHODS</b>49 patients with pneumoconiosis massive hemoptysis in observation group were underwent BAE, and 66 patients with pneumoconiosis hemoptysis in control group were cured with internal medicine. The rate of hemoptysis recurrence and controlling were counted during a year follow up.</p><p><b>RESULTS</b>The rate of hemoptysis recurrence in observation group was 18.8% (9/48), and in control group was 35.9% (23/64) during a year follow up, there was a significant difference (P < 0.05). The rate of massive hemoptysis recurrence in the both group were 4.2% (2/48) and 9.3% (6/64) respectively, there was not a significant difference (P > 0.05).</p><p><b>CONCLUSION</b>BAE is an effective technique in patients with pneumoconiosis massive hemoptysis.</p>

Bronchial artery embolization for hemoptysis: a retrospective observational study of 344 patients / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Hemoptysis is a significant clinical entity with high morbidity and potential mortality. Both medical management (in terms of resuscitation and bronchoscopic interventions) and surgery have severe limitations in these patients population. Bronchial artery embolization (BAE) represents the first-line treatment for hemoptysis. This article discusses clinical analysis, embolization approach, outcomes and complications of BAE for the treatment of hemoptysis.</p><p><b>METHODS</b>A retrospective analysis of 344 cases, who underwent bronchial arteriography at Tianjin Haihe Hospital between 2006 and 2013. Several aspects of outcome were analyzed: Demographics, clinical presentation, radiographic studies, results, complications and follow-up of BAE.</p><p><b>RESULTS</b>Three hundred and forty-four consecutive patients underwent bronchial arteriography, 336 of 344 patients (97.7%) performed BAE; there were 1530 coils for 920 arteries embolized; the main responsible sources for bleeding were right bronchial artery (29.7%), left bronchial artery (21.6%), combined right and left bronchial trunk (18.4%), right intercostal arteries (13.3%); 61 patients (17.7%) had recurrent hemoptysis within 1 month after undergoing BAE, 74 patients (21.5%) had recurrent hemoptysis over 1 month after undergoing BAE; The common complications of BAE included subintimal dissection, arterial perforation by a guide wire, fever, chest pain, dyspnea, etc. The follow-up was completed in 248 patients, 28 patients had been dead, 21 patients still bleed, 92 patients had lost to follow-up.</p><p><b>CONCLUSIONS</b>The technique of BAE is a relatively safe and effective method for controlling hemoptysis . The complications of BAE are rare. Although the long-term outcome in some patients is not good, BAE may be the only life-saving treatment option in patients who are poor surgical candidates.</p>

retrospective analysis of 334 cases of hemoptysis treated by bronchial artery embolization

To analyze the safety and efficacy of bronchial artery embolization [BAE] in the management of hemoptysis. We conducted a retrospective study of 334 patients who had undergone BAE for hemoptysis from January 2007 to July 2013. Our study included 255 [76.3%] males and 79 [23.7%] females with an age range from five to 81 years old. All relevant arteries were evaluated but only those arteries that showed hypertrophy and significant blush were targeted. Polyvinyl alcohol [PVA] was used in all patients and gel foam was used in combination with PVA where there was significant shunting. Mild hemoptysis was seen in 70 patients, moderate in 195 patients, and severe in 69 patients. On imaging, right side disease was seen in 101 patients, left side involvement in 59 patients, and bilateral involvement in 174 patients. Post-tubercular changes were the predominant pathology seen in 248 patients. Among 334 patients [386 procedures], 42 patients underwent the procedure twice and five patients underwent the procedure thrice. A total of 485 arteries were attempted of which 440 arteries were successfully embolized. Right intercosto-bronchial was the most common culprit artery present in 157 patients, followed by common bronchial [n=97], left bronchial [n=55], and right bronchial [n=45]. We embolized a maximum of four arteries in one session. Immediate complications such as dissection and rupture occurred in only nine sessions [2.3%]. Twenty-five procedures [6.5%] were repeated within two months, which were due to technical or clinical failure and 27 procedures [7%] were repeated after two months. BAE is a safe and effective procedure with a negligible complication rate. Our approach of targeting hypertrophied arteries was effective

Bronchial Artery Aneurysm Presenting as Hematemesis and Mediastinal Hemorrhage

Hematemesis is a rare manifestation of a ruptured bronchial artery aneurysm (BAA) in the mediastinum. It is difficult to diagnose a ruptured BAA presenting as hematemesis, because it can be confused with other diseases, such as Boerhaave's syndrome, variceal disease, or a perforated ulcer. In this report, we describe a case of BAA resulting in hematemesis and mediastinal hemorrhage.

Computed tomographic bronchioarterial ratio for brachycephalic dogs without pulmonary disease

The bronchoarterial (BA) ratio measured with computed tomography is widely used in human medicine to diagnose bronchial dilation or collapse. Although use of the BA ratio in veterinary medicine has been recently studied, this has not been evaluated in brachycephalic dogs predisposed to bronchial diseases including bronchial collapse. The purpose of this study was to establish BA ratios for brachycephalic dogs and compare the values with those of non-brachycephalic dogs. Twenty-three brachycephalic dogs and 15 non-brachycephalic dogs without clinical pulmonary disease were evaluated. The BA ratio of the lobar bronchi in the left and right cranial as well as the right middle, left, and right caudal lung lobes was measured. No significant difference in mean BA ratio was observed between lung lobes or the individual animals (p = 0.148). The mean BA ratio was 1.08 +/- 0.10 (99% CI = 0.98~1.18) for brachycephalic dogs and 1.51 +/- 0.05 (99% CI = 1.46~1.56) for the non-brachycephalic group. There was a significant difference between the mean BA ratios of the brachycephalic and non-brachycephalic groups (p = 0.00). Defining the normal limit of the BA ratio for brachycephalic breeds may be helpful for diagnosing bronchial disease in brachycephalic dogs.

Radiological Findings and Outcomes of Bronchial Artery Embolization in Cryptogenic Hemoptysis

Management of cryptogenic massive hemoptysis is difficult, and conservative treatment may be inadequate to stop the hemorrhage. Surgery is not a reasonable option because there is no underlying identifiable pathology. This study aimed to investigate the radiologic findings and bronchial artery embolization outcomes in cryptogenic hemoptysis, and to compare the results with non-cryptogenic hemoptysis. We evaluated 26 patients with cryptogenic hemoptysis and 152 patients with non-cryptogenic hemoptysis. A comparison of the bronchial artery abnormalities between the cryptogenic and non-cryptogenic hemoptysis groups showed that only extravasation was more statistically significant in the cryptogenic hemoptysis group than in the non-cryptogenic hemoptysis group, while the other bronchial artery abnormalities, such as bronchial artery dilatation, hypervascularity, and bronchial-to-pulmonary shunting, showed no significant difference between groups. Involvement of the non-bronchial systemic artery was significantly greater in the non-cryptogenic hemoptysis group than in the cryptogenic hemoptysis group. While 69.2% of patients with cryptogenic hemoptysis also had hypervascularity in the contralateral bronchial arteries and/or ipsilateral bronchial artery branches other than the bleeding lobar branches, this finding was not detected in non-cryptogenic hemoptysis. Embolization was performed on all patients using polyvinyl alcohol particles of 355-500 microm. Hemoptysis ceased in all patients immediately after embolization. While recurrence of hemoptysis showed no statistically significant difference between the cryptogenic and non-cryptogenic hemoptysis groups, it was mild in cryptogenic hemoptysis in contrast to mostly severe in non-cryptogenic hemoptysis. Transarterial embolization is a safe and effective technique to manage cryptogenic hemoptysis.

Aberrant Bronchial Artery to Non-Sequestrated Left Upper Lobe in Massive Hemoptysis / 결핵및호흡기질환

Systemic arterial supply from the descending thoracic aorta to the basal segment of the left lower lobe without a pulmonary arterial supply is a rare congenital anomaly within the spectrum of sequestration lung disease. The most common pattern of anomalous systemic artery to the lung arises from the descending thoracic aorta and feeds the basal segments of the left lower lobe. We report an extremely rare case of a 29-year-old woman who underwent a successful left upper lobectomy for the treatment of recurrent massive hemoptysis from anomalous bronchial arterial supply to the lingular segment of left upper lobe.

A Case of Interventional Lung Assist Application in a Patient with Pulmonary Arteriovenous Malformation Complicating Massive Hemoptysis / 계명의대학술지

Percutaneous bronchial artery embolization and lung resection surgery have been effective for treatments of hemoptysis in patients with pulmonary arteriovenous malformation (PAVM). But, it has been little known about management for recurrent massive hemoptsis in patients with PAVM. It has been reported that Pumpless Extracoporeal Interventional Lung Assist (iLA) are effective for removal of hypercapnea in patient with acute respiratory failure. Here, we report a case of iLA support in a patient with PAVM complicating massive hemoptysis. A 38 year old man developed recurrent massive hemoptysis although interventions of bronchial artery embolization and lung resection surgery. The cause of recurrent hemoptysis was turned out PAVM. After a massive hemoptysis, the patient had severe hypercapnea and acidosis though mechanical ventilation and oxygenation. After iLA implantation, the hypercapnea was resolved and the clinical condition of the patient was improved, temporally. In conclusion, iLA may be a useful for bridge support in patients with prolonged massive hemoptysis.

Treatment of Endobronchial Hemorrhage Using Balloon Tamponade and Bronchial Artery Embolization / 계명의대학술지

Endobronchial hemorrhage is common complication of bronchoscopic biopsy. There are several hemostatic methods including cold saline irrigation, topical vasoactive substance instillation, tranexamic acid treatment, and balloon tamponade. Insertion of balloon catheter into bronchoscopic working channel is relatively simple and useful method for the selective hemostasis. Here, we report a case of 75-year-old female patient who had hemorrhage during endobronchial biopsy with flexible bronchoscopy. Since primary treatments such as cold saline irrigation and epinephrine instillation had been failed to stop hemorrhage, balloon catheter was immediately inserted into the bleeding site for temporal hemostasis. And then, bronchial artery embolization was followed for the additional treatment of hemorrhage. We suggest to use balloon catheter as a bridge therapy before bronchial artery embolization.

Pulmonary Actinomycosis Associated with Endobronchial Vegetable Foreign Body

A 51-year-old woman visited our hospital with massive hemoptysis. She had suffered from recurrent hemoptysis for five years and had undergone bronchial artery embolization many times. The patient had a history of pulmonary tuberculosis and bronchiectasis. Chest radiography showed consolidation around the nodule in the lateral basal segment of the right lower lobe. We successfully performed a right lower lobectomy. The histological study of the resected specimen showed a vegetable foreign body and clumps of Actinomyces, indicating actinomycosis, which was suggested to be the cause of the hemoptysis. This was a very rare case of hemoptysis caused by a vegetable foreign body and actinomycosis.