Sakamoto Susumu, Kishi Kazuma, Homma Sakae, Kawabata Masateru, Tsuboi Eiyasu, Narui Koji, Nakatani Tatsuo, Kono Tadasu, Motoi Noriko, Nakata Koichiro, Yoshimura Kunihiko
Division of Respiratory Medicine, Toranomon Hospital, Tokyo, Japan.
Nihon Kokyuki Gakkai Zasshi. 2003 Dec;41(12):911-6.
We describe a case of catamenial pneumothorax caused by diaphragmatic endometriosis and histologically confirmed thoracoscopically. The patient was a 33-year-old woman who had had recurrent right chest pain starting on the day preceding each menstruation since she was 26 years of age. In June 2001, at the age of 33, she felt right chest pain and developed dyspnea, and so came to our hospital. Chest radiography showed bilateral pneumothorax. Timely thoracoscopy revealed the characteristic appearances of catamenial pneumothorax such as a blueberry spot on the central tendon of the right diaphragm and a purplish-red locus in the right apex. Histopathological examination further confirmed the presence of endometrial tissue on the diaphragm as well as in the lesion of the right lung. Despite resection of the endometrial tissues from the right hemidiaphragm and the lung under thoracoscopy, right pneumothorax recurred after one month. Since then, the patient's condition has been well controlled by therapy with gonadotropin releasing hormone, with no recurrence of catamenial pneumothorax.
我们描述了一例由膈肌子宫内膜异位症引起的经期气胸，并经胸腔镜组织学确诊。患者为一名33岁女性，自26岁起，每次月经前一天开始反复出现右胸痛。2001年6月，33岁时，她感到右胸痛并出现呼吸困难，遂来我院就诊。胸部X线检查显示双侧气胸。及时进行的胸腔镜检查发现了经期气胸的典型表现，如右膈肌中央腱上的蓝莓样斑点和右肺尖的紫红色病灶。组织病理学检查进一步证实膈肌及右肺病变处存在子宫内膜组织。尽管在胸腔镜下切除了右半膈肌和肺部的子宫内膜组织，但一个月后右气胸复发。从那时起，患者的病情通过促性腺激素释放激素治疗得到了良好控制，经期气胸未再复发。
