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Black BronchoscopyBlack Bronchoscopy

Pichapong Tunsupon, MD; Tanmay S. Panchabhai, MD; Danai Khemasuwan, MD, MBA; Atul C. Mehta, MD, FCCP
Author and Funding Information

From Internal Medicine, Medicine Institute (Dr Tunsupon) and Pulmonary, Allergy and Critical Care Medicine, Respiratory Institute (Drs Panchabhai, Khemasuwan, and Mehta), Cleveland Clinic, Cleveland, OH

Correspondence to: Atul C. Mehta, MD, FCCP, Pulmonary, Allergy and Critical Care Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, OH 44195; e-mail: Mehtaa1@ccf.org


Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2013;144(5):1696-1706. doi:10.1378/chest.13-0981
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A presence of black pigmentation involving the endobronchial tree is not uncommon. It was first described in the literature in association with occupational exposure in the early 1940s. However, in 2003, Packham and Yeow formally used the term black bronchoscopy to describe endobronchial metastasis from a malignant melanoma. Hyperpigmentation of the airway, however, is associated with multiple etiologies such as congenital disease, inborn errors of metabolism, infections, environmental exposures, neoplasm, and iatrogenic causes. Although the majority of these conditions are benign, a proper diagnosis is important for optimal management. In this article, we review the etiology of black bronchoscopy and discuss its presentations and current management guidelines.

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