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[Perihilar interstitial bleeding due to thoracic endometriosis]
H Hoshino1, H Takahashi, S Kobayashi
1Third Department of Internal Medicine, Sapporo Medical University School of Medicine, Japan.
Summary
This rare case highlights pulmonary endometriosis, a condition where endometrial tissue grows in the lungs. Magnetic resonance (MR) imaging proved crucial in diagnosing this interstitial lung disease.
Area of Science:
- Pulmonary Medicine
- Radiology
- Gynecology
Background:
- Endometriosis is a condition where tissue similar to the uterine lining grows outside the uterus.
- Pulmonary endometriosis is an extremely rare manifestation, often presenting with catamenial symptoms like cyclical hemoptysis.
- Diagnosis can be challenging due to its rarity and nonspecific symptoms.
Observation:
- A 47-year-old woman presented with a left hilar mass and cyclical hemoptysis synchronized with menstruation.
- Computed tomography (CT) revealed a non-enhancing mass.
- Chest X-ray showed mass enlargement and infiltrative shadows during hemoptysis.
Findings:
- Magnetic resonance (MR) imaging demonstrated a fluid-fluid level within the mass on T2-weighted images.
- Abnormal signals indicated interstitial spread into the lung parenchyma.
- MR imaging showed intensity changes consistent with intracranial bleeding over time, aiding diagnosis.
Implications:
- This case underscores the importance of considering pulmonary endometriosis in women with cyclical hemoptysis and hilar masses.
- Magnetic resonance (MR) imaging is a valuable tool for diagnosing pulmonary endometriosis, particularly in visualizing interstitial changes and hemorrhage.
- Early and accurate diagnosis through advanced imaging can lead to timely management of this rare pulmonary condition.