To the Editor.
—The fiberoptic bronchoscope is not normally included as a diagnostic instrument in the evaluation of left-sided chest pain. We recently had the opportunity to examine bronchoscopically a 52-year-old man with extensive pulmonary parenchymal damage, fibrosis, and cavitary lesions associated with infection by Mycobacterium kansasii. There was evidence of left pleural thickening on his chest roentgenograms, together with infiltrative lesions in the left upper lobe and lingula associated with mild-to-moderate hemoptysis. The subsegmental orifices to the left upper lobe (B1, B2, and B3) and the lingular divisions (B4 and B5) were instrumented with successful localization of the bleeding point.Following the procedure, the patient volunteered that he had experienced left-sided chest pain radiating into the left shoulder during the examination of the left upper lobe bronchi. This pain duplicated the discomfort for which he had twice previously undergone coronary cineangiography at other institutions
Payne CB. Fiberoptic Bronchoscope. Arch Intern Med. 1980;140(12):1673–1674. doi:10.1001/archinte.1980.00330230119028