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Coughing up blood
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Coughing up blood

In April and May of 2008 I began coughing up blood.  This comes on by having a wheezing episode and then I begin coughing.  This brings on the process of coughing up blood.  It may happen several days in a row or may be months in between.  The blood is bright red and may contain some mucus in it.  The blood sample is about a quarter size and may happen 3 to 6 times in a row.  I have had a lung spirometer test, sputum sample, a bronscopy, lung biopsy, multiple CAT scans, multiple chest x-rays, a PET scan and many many blood tests.  All of these tests have come back insignifant.  My current diagnosis is lung cavity disease.  I was initially diagnosed with asthma and COPD.  Since then the Pulmonologist has taken off the COPD diagnosis.  Since this had not happened for several months we thought it might be over.  However, Sunday it started again.  I am a 40 year old causian female with the only other diagnosis of chronic fatigue and positive epstein bar virus. I was a previous smoker for about 20 years and have been a totally non-smoker since Dec. 19th 2006.   Any insight would be very helpful.  Thanks so much!!
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The statement that all tests and procedures were insignificant (presumably normal or negative) and then the statement that your diagnosis is “lung cavity disease”, is contradictory.  A lung cavity is, by definition, abnormal and, regardless of the cause, could be responsible for the blood.

Now, if that is not the case and your CT, chest X-rays and PET scan are normal then your doctors should look to the unexamined parts of your respiratory tract, namely your nose and sinuses.  It is also conceivable that the source could be gastrointestinal, from your esophagus.

Your sputum should also be examined to make sure it is blood and not some other, regurgitated material that looks bloody.  

There is one other possibility, a rare condition called Pulmonary Endometriosis.  It results in bleeding from endometrial (uterine lining) tissue that has settled in the lung and results in coughing up blood either just before the onset or during menstruation.  If present, this should have been seen on the CT Scan but, if small, not necessarily so.  You might want to try to recall if the bleeding has accompanied menstruation.

Good luck
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