[A patient with pulmonary endometriosis]
J P L'huillier1, J Salat-Baroux
1Cabinet de Pneumologie, 112, avenue du Bac, 94210 La Varenne-Saint-Hilaire, France. lhuillier.jean-pierre@wanadoo.fr
Revue De Pneumologie Clinique
|October 31, 2002
Summary
Catamenial hemoptysis, a rare symptom of bronchopulmonary endometriosis, can occur cyclically with menstruation. This case highlights the importance of considering endometriosis in women with recurrent hemoptysis, especially after uterine procedures.
Area of Science:
- Reproductive Medicine
- Pulmonology
- Gynecologic Oncology
Background:
- Bronchopulmonary endometriosis is a rare condition characterized by endometrial tissue outside the uterus, potentially affecting the lungs.
- Catamenial hemoptysis, or coughing up blood related to menstruation, is the primary symptom.
Observation:
- A 30-year-old woman presented with recurrent hemoptysis coinciding with her menstrual cycle, following cessation of estrogen-progesterone therapy.
- Initial investigations including physical exam, chest X-rays, and bronchial endoscopy were normal.
- Thoracic CT revealed a transient alveolar opacity, and laparoscopy identified pelvic endometriosis.
Findings:
- The patient's hemoptysis resolved after laparoscopic removal of the endometrial nodule and subsequent treatment with a gonadotropin-releasing hormone agonist (triptoreline).
- Diagnosis of bronchopulmonary endometriosis can be challenging due to non-specific imaging and endoscopic findings.
- A history of uterine procedures is often associated with this condition, suggesting hematogenic or lymphatic spread.
Implications:
- This case underscores the importance of considering endometriosis in the differential diagnosis of cyclical hemoptysis in women.
- Early diagnosis and appropriate treatment, such as LH-RH agonists, can effectively manage symptoms and prevent recurrence.
- Further research into the pathogenesis and diagnostic modalities for extrapulmonary endometriosis is warranted.
