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胸腔子宫内膜异位症综合征:一个名副其实的潘多拉魔盒。

Thoracic Endometriosis Syndrome: A Veritable Pandora's Box.

作者信息

Nair Sobha S, Nayar Jayashree

机构信息

Assisstant Professor, Department of Obstetrics and Gynaecology, Amrita Institute of Medical Sciences , Kochi, Kerala, India .

Professor, Department of Obstetrics and Gynaecology, Amrita Institute of Medical Sciences , Kochi, Kerala, India .

出版信息

J Clin Diagn Res. 2016 Apr;10(4):QR04-8. doi: 10.7860/JCDR/2016/17668.7700. Epub 2016 Apr 1.

Abstract

Thoracic endometriosis syndrome is a rare disorder characterised by the presence of functioning endometrial tissue in pleura, lung parenchyma, airways, and/or encompasses mainly four clinical entities-catamenial pneumothorax, catamenial haemothorax, catamenial haemoptysis and lung nodules. The cases were studied retrospectively by reviewing the records at Amrita Institute of Medical Sciences, for duration of five years i.e., form March 2010-2014 and analysed for the clinical presentation and management of thoracic endometriosis syndrome. Catamenial breathlessness was the main symptom. Pneumothorax and pleural effusion were the findings on investigations. Histopathology report of endometriosis was present in three cases (50%). Conditions with excess oestrogen like endometriosis, fibroid, adenomyosis were diagnosed in these patients by pelvic scan. After the initial supportive treatment with hormones, pleurodesis, hysterectomy and lung decortication were the treatment modalities. Two cases that had multiple recurrences were diagnosed as disseminated TES. They underwent combined treatment of surgery and hormones.

摘要

胸段子宫内膜异位症综合征是一种罕见疾病,其特征是在胸膜、肺实质、气道中存在有功能的子宫内膜组织,并且/或者主要包括四种临床类型——经期气胸、经期血胸、经期咯血和肺结节。通过回顾阿姆里塔医学科学研究所五年(即2010年3月至2014年)期间的记录,对这些病例进行了回顾性研究,并分析了胸段子宫内膜异位症综合征的临床表现和治疗情况。经期呼吸困难是主要症状。气胸和胸腔积液是检查结果。三例(50%)有子宫内膜异位症的组织病理学报告。通过盆腔扫描在这些患者中诊断出患有雌激素过多相关疾病,如子宫内膜异位症、子宫肌瘤、子宫腺肌病。在最初采用激素进行支持治疗后,胸膜固定术、子宫切除术和肺纤维板剥脱术是治疗方式。两例有多次复发的病例被诊断为播散性胸段子宫内膜异位症综合征。他们接受了手术和激素的联合治疗。

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