Hemoptysis: a serendipitous discovery

The etiology of hemoptysis can sometimes be difficult to identify and requires a complete and sequential approach. It is also important to initially maintain a broad differential diagnosis. We present a patient who had an extremely rare adenoid cystic carcinoma of the nasopharynx as the cause of hemoptysis. This also highlights the importance of having a uniformly systematic approach to bronchoscopic inspection, with careful attention to areas beyond the actual tracheobronchial tree. Often, the nasopharyngeal and oropharyngeal regions are not as meticulously inspected during bronchoscopy. The fact that careful attention to both nares by bronchoscopic inspection aided the final diagnosis suggests that a thorough examination to these often overlooked areas should be routine.