Alifano M, Camilleri-Broët S
Service de chirurgie thoracique, Hôtel-Dieu, AP-HP, Paris, France.
Rev Mal Respir. 2008 Oct;25(8):966-72. doi: 10.1016/s0761-8425(08)74413-9.
Thoracic endometriosis has been considered a rare clinical condition but it is probably underestimated in the literature. Various clinical symptoms may occur but the most frequent are catamenial pneumothoraces. Four main clinical conditions may reveal thoracic endometriosis: catamenial pneumothorax, catamenial haemothorax, catamenial haemoptysis and endometrial nodules in the lung. Catamenial pneumothoraces are the most frequent manifestation, characterized, in the majority of the cases, by right side localization and diaphragmatic abnormalities (perforations and/or nodules). The resection of suspected areas of visceral or parietal pleural endometriosis, as well as partial resection of the diaphragm in the case of nodules and/or perforations, allows the histological diagnosis of endometriosis. Because of the high recurrence rate, treatment of catamenial pneumothoraces should combine surgery and hormonal therapy.
胸腔子宫内膜异位症一直被认为是一种罕见的临床病症,但在文献中可能被低估了。可能会出现各种临床症状,但最常见的是经期气胸。有四种主要临床情况可提示胸腔子宫内膜异位症:经期气胸、经期血胸、经期咯血和肺部子宫内膜结节。经期气胸是最常见的表现,在大多数病例中,其特征为右侧定位和膈肌异常(穿孔和/或结节)。切除可疑的脏层或壁层胸膜子宫内膜异位症区域,以及在出现结节和/或穿孔时对膈肌进行部分切除,可实现子宫内膜异位症的组织学诊断。由于复发率高,经期气胸的治疗应将手术和激素治疗相结合。