CTICasesPost-Bronchoscopy Organizing Hematoma ("Bronc Bite")
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Imaging findings
Initial CT chest shows a suspicious solid pulmonary nodule. Following an unsuccessful navigational bronchoscopy and biopsy attempt, a follow-up CT reveals a new, large, 2.5 cm, well-circumscribed, soft-tissue attenuation mass containing a central airway and a pseudo-cavity directly adjacent to the nodule. Resection specimen confirms a large organizing hematoma surrounded by a fibrous capsule.
Key takeaways
Lung biopsy and bronchoscopy can cause localized airway hemorrhage, occasionally resulting in a rapidly developing, well-demarcated hematoma ("bronc bite"). On subsequent imaging, these post-procedural hematomas can mimic rapid disease progression, a secondary tumor, or infection, but their sterile, well-circumscribed appearance and location along the biopsy tract are key clues to their benign, post-traumatic nature.
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