Should patients with haemoptysis and a normal chest X-ray be bronchoscoped?

A review of bronchoscopic records over a 5 year period identified 41 patients who had undergone fibreoptic bronchoscopy after presenting with haemoptysis and a normal chest X-ray. Carcinoma of the bronchus was found in 4 patients (9.7%) and the procedure yielded a diagnosis in 8 of the 20 patients in whom a specific cause of their bleeding could be identified. The diagnostic yield is sufficiently high and the morbidity of the procedure sufficiently low to justify the investigation in patients presenting with haemoptysis and a normal chest X-ray.