Augoulea Areti, Lambrinoudaki Irene, Christodoulakos George
2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieion Hospital, Athens, Greece.
Respiration. 2008;75(1):113-9. doi: 10.1159/000105102. Epub 2007 Jun 28.
Endometriosis is defined as the presence of endometrial glands and stroma outside the uterine cavity and is usually confined to the pelvis. Thoracic endometriosis syndrome (TES) is a rare disorder characterized by the presence of functioning endometrial tissue in the pleura, the lung parenchyma and the airways. TES may present with hemoptysis, due to the shedding of endometrial tissue in the bronchial tree, or spontaneous pneumothorax or hemothorax if the endometrial tissue is localized peripherally. Patients are of reproductive age, often nulliparous, with long-standing symptoms. The crucial issue for establishing the diagnosis is the cyclicity of the symptoms which occur along with the menstrual cycle. TES is virtually a diagnosis of exclusion, established on clinical grounds, since neither CT nor endoscopy are specific for TES. Treatment consists of gonadotropin-releasing hormone analogues, aiming to suppress the hypophyseal-gonadal axis, so as to ensure a regression of the endometrial implants. If medical treatment fails, surgical resection of the endometriomas is suggested, although relapse rate may be high.
子宫内膜异位症的定义为子宫腔外存在子宫内膜腺体和间质，通常局限于盆腔。胸段子宫内膜异位症综合征（TES）是一种罕见疾病，其特征为在胸膜、肺实质和气道中存在有功能的子宫内膜组织。TES可能因支气管树中子宫内膜组织脱落而出现咯血，或者如果子宫内膜组织位于外周，则可能出现自发性气胸或血胸。患者处于生育年龄，通常未生育，症状持续时间长。确立诊断的关键问题是症状与月经周期同步出现。由于CT和内镜检查对TES均无特异性，TES实际上是基于临床依据的排除性诊断。治疗方法包括促性腺激素释放激素类似物，旨在抑制垂体-性腺轴，以确保子宫内膜植入物消退。如果药物治疗失败，建议手术切除子宫内膜瘤，尽管复发率可能较高。
