Department of Surgery, China Medical University, Taichung, Taiwan.
Respir Care. 2012 Jul;57(7):1182-5. doi: 10.4187/respcare.01256. Epub 2012 Jan 23.
Co-existence of catamenial pneumothorax and hemoptysis is rare. We present a case of catamenial pneumothorax due to bilateral pulmonary endometriosis in a 45-year-old woman. The patient presented with a 3-year history of intermittent productive cough with blood-tinged sputum, chronic anemia, loss of appetite, and general weakness associated with menstruation. Three years prior to this presentation the patient had undergone a sigmoidectomy as treatment for endometriosis of the sigmoid colon with bleeding. Chest radiographs and computed tomography (CT) scan revealed multiple nodules in both lung parenchyma and recurrent pneumothorax. CT-guided biopsy revealed chronic inflammation of those pulmonary nodules, and laboratory studies disclosed elevated serum levels of carbohydrate antigen 19-9 (CA 19-9) and CA 125. Thoracoscopic wedge resection of the pulmonary nodules was performed, and histopathological examination of the resected nodules revealed endometriosis. At one-year follow-up there was no evidence of recurrence of gastrointestinal bleeding or pneumothorax.
月经性气胸合并咯血较为罕见。我们报告了一例 45 岁女性因双侧肺子宫内膜异位症导致的月经性气胸。该患者表现为间歇性咯血性咳嗽 3 年，伴有慢性贫血、食欲不振和全身乏力，这些症状与月经周期有关。在本次就诊前 3 年，该患者因乙状结肠子宫内膜异位症伴出血接受了乙状结肠切除术。胸部 X 线片和计算机断层扫描（CT）显示双肺实质内多个结节和复发性气胸。CT 引导下活检显示这些肺结节存在慢性炎症，实验室研究显示血清糖链抗原 19-9（CA 19-9）和 CA 125 水平升高。对肺结节进行了电视胸腔镜楔形切除术，切除结节的组织病理学检查显示为子宫内膜异位症。随访 1 年，未发现胃肠道出血或气胸复发的证据。
