Ishibashi Naoya, Tabata Toshiharu, Koyanagi Akira, Nonomura Ryo, Sasaki Takanobu, Mitomo Hideki, Sugawara Takafumi, Kondo Takashi, Murakami Kazuhiro, Sagawa Motoyasu
Division of Thoracic Surgery,Tohoku Medical and Pharmaceutical University, Sendai, Japan.
Kyobu Geka. 2019 Feb;72(2):87-91.
We retrospectively assessed the clinical and pathological features of 14 patients with thoracic endometriosis who were treated at our hospital from 2007 to 2017. Thirteen patients presented pneumothorax and 1 patient presented bloody sputum. All were treated surgically. Pneumothorax occurs on the right side in all 13 cases and bloody sputum was from left side lesion. Ten patients presented symptoms closely related with their menstrual cycle (days -2 to 5). At surgery, dark red or dark brown spots, small hiatus and scar-like findings on the surface of the visceral pleura or diaphragm were identified in all cases. Pathological or immunohistochemical examinations of diaphragm or lung tissue specimens revealed endometrial tissue in 6 cases of pneumothorax and a case of bloody sputum. Nine patients received hormonal therapy(8:pneumothorax, 1:bloody sputum). Pleurodesis was performed for 1 pneumothorax patient with recurrent pneumothorax after hormonal therapy. In case of young female with repeated pneumothorax, catamenial pneumothorax must be kept in mind as a differential diagnosis and appropriate timing for surgical treatment should be considered to establish pathologically correct diagnosis.
我们回顾性评估了2007年至2017年在我院接受治疗的14例胸段子宫内膜异位症患者的临床和病理特征。13例患者出现气胸,1例患者出现咯血。所有患者均接受了手术治疗。13例气胸均发生在右侧,咯血来自左侧病变。10例患者出现与月经周期密切相关的症状(月经周期第-2至5天)。手术时,所有病例均在内脏胸膜或膈肌表面发现暗红色或深褐色斑点、小裂隙和瘢痕样表现。膈肌或肺组织标本的病理或免疫组化检查显示,6例气胸患者和1例咯血患者存在子宫内膜组织。9例患者接受了激素治疗(8例气胸,1例咯血)。1例气胸患者在激素治疗后出现复发性气胸,接受了胸膜固定术。对于反复出现气胸的年轻女性,必须考虑月经性气胸作为鉴别诊断,并应考虑在适当的时候进行手术治疗,以建立病理正确的诊断。