# Endobronchial valves– an iatrogenic cause of hemoptysis to be considered at autopsy

## TL;DR

This case study highlights that endobronchial valves, used to treat COPD, can rarely cause hemoptysis due to granulation tissue formation.

## Contribution

It presents a rare iatrogenic cause of hemoptysis linked to endobronchial valve insertion.

## Key findings

- The patient's hemoptysis was caused by granulation tissue from endobronchial valves.
- Iatrogenic causes should be considered in autopsies of COPD patients with hemoptysis.
- Treatment-related complications can mimic underlying lung diseases.

## Abstract

An 80-year-old man who presented with hemoptysis died from ischemic heart disease and emphysema with cor pulmonale. He had a past history of ischemic heart disease with previous myocardial infarction, chronic obstructive pulmonary disease with endobronchial valve insertion and squamous cell carcinoma of the lung with lobe resection. On the day of death he had coughed up approximately one tablespoon of blood. While causes of hemoptysis usually include entities such as bronchitis, pneumonia, bronchiectasis, tumors, adjacent aneurysms, inflammatory/infective processes or septic emboli, occasionally there may be an iatrogenic etiology. The present case demonstrates a rare cause of hemoptysis associated with medical treatment - endobronchial valve insertion with surrounding granulation tissue formation and resultant hemorrhage. Hemoptysis in decedents with COPD may, therefore, be due to treatment rather than to underlying inflammatory or neoplastic lesions.