Blook in Sputum

[mr roko]

I have something in my mind that worries me for quite some time now and I still can't find the answer for doctors. Almost a year ago, one morning I had blood in the sputum. Here I want to mention that I am not a smoker and I am 24 years old. It seemed to be quite a lot so I went to ER, they did and X-Ray and sent it to a pulmunary specialist which I had to visit a week later. He said that he sees some pneumonia and also some abnormalities in one of my lungs so he suggested I do a CT Scan. I did the CT scan and a couple of more X-Rays and at the end all that he could see was some scarring tissue and 2 cysts in one my lungs. He said this could be normal considering that I have a history of ARDS after a car accident and I was in the hospital on a ventilator about 4 years ago. That was about a month after the blood sputum happend and it was long gone by now. I decided to further check and I went to a nose doctor because ever since I got out of the hospital years ago I keep having a lot of mucus going and I decided to problem could be in my nose. The nose doctor did a CT Scan as well and could not find anything abnormal. Now after almost a year later I have a reoccurance of the blood in sputum. This time I am less worried because I know it is not a cancer after all the scans that I previously did but still I would want to know what causes it. I haven't been to a doctor this time and I hope someone could tell me something in here. Thanks.

[mr roko]

Thank you for the advise. I don't have any periods when I actively have blood in my sputum. It was only once, the first time when it occured and it lasted for 2 days on and off. The last time when I actually posted my concern the blood was only in the early morning until noon and it disappeared after this. I noticed that when it occured, i could have some blood in my sputum and then it is gone, but if I force myself with a very hard cough sometimes it would come back. It almost seems that the source is like a wound or something which when forced bleeds a little. This is only during episodes when the bleeding occurs though. If I force a hard cough at some other time no blood occurs. I guess the best decision will be to have a laringoscopy at some point. The first time when this occured i had 3 or 4 x-rays + 2 CT scans, one on my nose and one on my chest. I am not sure if another x-ray will show anything different but a brochoscopy should be helpful. I guess my main concern was that I have some kind of cancer at first but after all the scans that I had that didn't seem as a possibility. At least I hope it is not.  

[National Jewish]

You should first have a careful exam of your nose and upper airways, by an ENT specialist, using a fiberoptic laryngoscope to see if a source of bleeding is in those upper airways.  If not, you should have another chest x-ray and a bronchoscopy to look for a site of bleeding in the lower airways.  It is possible that bleeding could arise from one of the 'cysts'.  Ideally, the bronchoscopy should be done at a time when you are actively raising blood in your sputum.