Question 15: HIV patient with increasing chest discomfort. The study was requested to rule out a pulmonary embolism. What is the diagnosis?

Bronchial Arteries Enlarged as the Cause of Hemoptysis

CT of the Bronchial Arteries

• The bronchial arteries arise directly from the descending aorta and supply blood to the airways, esophagus and lymph nodes
• The left bronchial arteries arise from the anterior surface of the aorta or the concavity of the arch
• The right bronchial arteries arise from the posterolateral aspect of the thoracic aorta

Massive Hemoptysis: Common Etiologies

• Pulmonary TB
• Bronchogenic carcinoma
• Cystic fibrosis
• Aspergillosis
• Lung abscess
• Pneumonia
• Pulmonary artery aneurysm

"A bronchial artery with a diameter of greater than 2 mm is considered to be abnormal and may be the source of hemoptysis. Extravasation of contrast medium, a specific sign of bronchial bleeding is occasionally seen; its reported prevalence is 4-11%."

Bronchial and Nonbronchial Systemic Arteries in patients with Hemoptysis: Detection on MDCT Angiography
Chung MJ et al.
AJR 2006;186:649-655