[A case of tuberculosis in which hemoptysis was caused by bleeding from intercostal arteries]

A 60-year-old man was referred to our hospital because of persistent hemoptysis. Chest roentgenogram and computed tomogram revealed that the right hemithorax was almost completely occupied by solid material with scattered calcifications. Mycobacteria were detected in the sputum culture. Administration of antituberculosis agents began after admission. Four months after admission, massive hemoptysis occurred. Topical treatment via fiberoptic bronchoscopy resulted in no improvement. Surgical resection of the right lung would probably have been difficult because of the almost complete collapse of the right lung and the extensive calcifications within the right hemithorax. Angiographic examination revealed extravasation of contrast medium from the right 7th, 8th, 9th, 10th, and 12th intercostal arteries. After transcatheter embolization of each of these intercostal arteries, hemoptysis stopped. It is unclear how bleeding from intercostal arteries caused massive hemoptysis, but the bleeding may have caused a right hemothorax that drained into an airway.