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Pulmonary tuberculosis is a common disease that may result in hemoptysis. Fetal hemoptysis is known to be related to the rupture of a pulmonary aneurysm formed in the cavity wall. We herein report a case of non-cavity pulmonary tuberculosis that developed with massive hemoptysis following bronchial artery aneurysm. Bronchial artery embolization was performed, and autofluorescence imaging bronchoscopy was conducted one month after the anti-tuberculosis treatment. Bright-green color was observed in the ulcerative lesion with a white coat, corresponding to the bronchial artery aneurysm. This is the first report of the autofluorescence imaging observation of an ulcerative lesion caused by bronchial tuberculosis.

A 24-year-old man who had uveitis and showed intrathoracic lymph node swelling on a chest X-ray, was admitted to our hospital for further examination. Transbronchial lung biopsy specimens revealed non-caseating granulomas compatible to sarcoidosis. As the renal function became progressively worse, a specimen was obtained by renal biopsy. It showed a granuloma formation, and was diagnosed as renal sarcoidosis. A high level of interleukin(IL)-6 was detected in his urine. After oral administration of prednisolone, the renal function improved, and the urinary IL-6 level was reduced. These findings suggest that in sarcoidosis associated with renal failure, steroid therapy is effective and that IL-6 plays an important role in the pathogenesis of renal involvement of sarcoidosis.(Internal Medicine 37: 757-761, 1998)