A case of massive hemoptysis related to a smoking-history: An acquired form of the Dieulafoy's disease?

The hypervascularization of the bronquial wall,secondary to chronic bronchopulmonary inflammation is a bleeding etiology in smokers,but insufficient to explain certain massive recurrent cases. we report a case of a woman with a smoking history who presented a recurrent and massive hemoptysis. a diagnostic study with laboratory tests,bronchoscopy,computed tomography and echocardiogram did not identify the etiological cause. however,bronchial arteriography showed right and left bronchial tortuous and dilated arteries and demonstrated that a bronchovascular fistula was the origin of the hemoptysis. an acquired form of the dieulafoy's disease in this context of a smoking history might justify such findings. bronchial arteriography as a diagnostic method should be the preferred choice rather than bronchoscopy in these cases. © 2015 sociedade portuguesa de pneumologia.