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Some of the causes of coughing up blood are as follows: Pulmonary embolism (blood clot in the lungs) Aspiration (accidental entry of food or other material into the lungs) Lung cancer Violent or excessive coughing Lung infections such as pneumonia Bronchoscopy with biopsy Bronchiectasis (a condition that causes enlargement of the arteries in the lungs) Bronchitis (inflammation of the inner lining of the bronchi present in the lungs) Cystic fibrosis Vasculitis (inflammation of the blood vessels in the lungs) Injury to the arteries of the lungs Pulmonary edema (a condition caused by excess fluid in the lungs) Congestive heart failure Autoimmune conditions such as lupus Tuberculosis Certain medications Is a little blood in phlegm normal