I think that we should keep the patient - at least for diagnostic.
It seems like haematological problem, but it's only a hunch.
Definitely we shall look for a reason of haemoptysis.
At the moment we aren't having much information, but basic tests should say us something:
- morphology
- ESR
- chest X-ray

I also would like to ask about:
- patients medicines
- age
- other complains: ostealgia?
- other diseases?
- professional and free time history
- alcohol, cigarettes, drugs

My intuition says it could be Wegener's granulomatosis. I see quite a lot of factors that could support this theory. His age, the upper respiratory tract inflammation, the X-ray infiltrations,h aemoptysis, involvement of the musculosceletal system with myalgia and arthralgia,leuk ocytosis.To confirm my suspicions I'd run urea and crea and urinalysis for proteinuria and haematuria.If kidneys were involved I'd do a renal biopsy. c-ANCA are also very specific(95%) for Wegenr's. The treatment in this case would be corticosteroids and cyclophosphamid e.