Nemeş Roxana Maria, Paleru Cristian, Dănăilă Olga, Ianoşi Edith Simona, Pop Corina Silvia, DiŢescu Damian, Streba Costin Teodor, NiŢu Mimi Floarea
Department of Thoracic Surgery, Institute of Pulmonology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania;
Rom J Morphol Embryol. 2015;56(1):295-300.
This paper describes a case of thoracic endometriosis in 36-year-old woman with a long delay in diagnosis. At the admission in the hospital, the patient had a medical history of persistent dysmenorrhea since the age of 13, infertility and an episode of total right pneumothorax two months ago successfully resolved by minimum pleurotomy of the right hemitorax. She came with moderate pain on right hemithorax and dyspnea, which occurred on the first day of menstruation but she did not have any other respiratory symptoms such as hemoptysis, cough. Radiological imaging (chest radiography and computer tomography) at the time of admission confirmed recurrence of the right pneumothorax. She underwent surgical treatment of the right pneumothorax using a single-port video-assisted approach. Intraoperative macroscopic lesions were found catamenial pneumothorax characteristic diagnosis and biopsy material taken (parietal pleura) for histopathology. Immuno-histochemical tests confirmed the diagnosis of thoracic endometriosis. The gonadotropin-releasing hormone analogue was received by the patient early after surgery and there was no clinical or radiological recurrence at a four months follow-up.
本文描述了一名36岁女性胸段子宫内膜异位症的病例,该病例诊断延误时间较长。入院时,患者有自13岁起持续痛经、不孕的病史,两个月前曾发生一次右侧全气胸,通过右侧半胸微创胸膜切开术成功治愈。她因右侧半胸中度疼痛和呼吸困难前来就诊,这些症状在月经第一天出现,但她没有咯血、咳嗽等其他呼吸道症状。入院时的放射影像学检查(胸部X线摄影和计算机断层扫描)证实右侧气胸复发。她采用单孔电视辅助方法接受了右侧气胸的手术治疗。术中发现具有月经期气胸特征性诊断的宏观病变,并取活检材料(壁层胸膜)进行组织病理学检查。免疫组织化学检测证实了胸段子宫内膜异位症的诊断。患者术后早期接受了促性腺激素释放激素类似物治疗,在四个月的随访中没有临床或放射学复发。