"Black bronchoscopy"-a case of endobronchial metastases from melanoma

The presence of black pigmentation in the airways during flexible bronchoscopy is uncommon. We report an unusual case of "black bronchoscopy" as a result of endobronchial metastases in a 77-year-old Chinese man, who presented with hemoptysis and postobstructive pneumonia 3 years after initial excision of a skin melanoma. Chest radiograph showed right lower lobe consolidation and collapse. Bronchoscopy showed narrowed airways with black pigmentation involving the lower trachea and right main bronchus. Biopsy confirmed metastatic melanoma. The patient received palliative radiation and died 6 months later. We review the causes of black airway pigmentation. We also briefly review the prevalence, clinical presentation, and prognosis of endobronchial metastases.