Catamenial pneumothorax with bullae
Yo Kawaguchi1, Takuya Fujita1, Jun Hanaoka2
1Division of General Thoracic Surgery, Kohka Public Hospital, Kohka, Shiga, Japan.
The Annals of Thoracic Surgery
|March 7, 2015
Summary
Catamenial pneumothorax, linked to endometriosis, may involve endometrial cells causing lung bullae. This suggests a novel mechanism for spontaneous pneumothorax requiring careful histologic diagnosis.
Area of Science:
- Pulmonology
- Gynecology
- Pathology
Background:
- Catamenial pneumothorax (CP) pathophysiology and diagnosis are debated.
- Intrathoracic endometriosis is an underrecognized cause of secondary spontaneous pneumothorax (SSP).
Observation:
- Three patients with CP presented with coexisting bullae.
- Endometrial cells were identified in proximity to the bullae in these patients.
Findings:
- A potential new mechanism for CP is proposed: cyclic endometrial shedding within the lung leads to alveolar epithelial cell destruction and bulla formation.
- Histologic examination is crucial for diagnosing thoracic endometriosis.
Implications:
- This finding may refine the understanding of CP mechanisms.
- Highlights the importance of considering endometriosis in patients with recurrent pneumothorax.
- Suggests a need for targeted diagnostic approaches for intrathoracic endometriosis.
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