A 39-year-old African American man presented with massive hemoptysis. He was known to have a history of type III sarcoidosis and a chest x-ray consistent with aspergilloma. Bronchoscopy was performed within 48 hours from the onset of the patient's symptoms revealing generalized heme in both the left and right main bronchi. Massive hemoptysis is a potentially life-threatening complication from a variety of diseases. This case serves to illustrate the diagnostic considerations and potential therapeutic interventions in patients with advanced sarcoidosis.
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