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[伴有周期性咯血的肺子宫内膜异位症]

[Pulmonary endometriosis with recurrent catamenial hemoptysis].

作者信息

Ueno H, Mukae H, Taniguchi H, Maki H, Ashitani J, Ihi T, Sakamoto A, Matsukura S

机构信息

Third Department of Internal Medicine, Miyazaki Medical College, Japan.

出版信息

Nihon Kyobu Shikkan Gakkai Zasshi. 1995 Aug;33(8):888-93.

PMID:7474572
Abstract

A 32-year-old woman with a history of dilation and curettage for missed abortion at 31 years old had sudden hemoptysis during menstruation on May 25, 1993. She had catamenial hemoptysis again, and was admitted to our hospital on July 21, 1993. After admission, catamenial hemoptysis occurred, and a nodular shadow was noted in the right S4 area on chest roentgenogram and computed tomogram. A few days after menstruation, hemoptysis and the abnormal shadow on chest roentgenogram disappeared. Pulmonary endometriosis was diagnosed by clinical course, past history, and chest roentgenographic findings. During the next menstruation, hemoptysis and a nodular shadow in the right S4 area on chest roentgenogram recurred, so transbronchial lung biopsy and laparoscopy were done. TBLB specimens revealed macrophages with phagocytosed hemosiderin, and laparoscopy revealed pelvic endometriosis. She was treated with buserelin acetate. Catamenial hemoptysis and the nodular shadow on the chest roentgenogram disappeared after treatment.

摘要

一名32岁女性,31岁时因稽留流产行刮宫术,1993年5月25日月经期间突然咯血。她再次出现经期咯血,并于1993年7月21日入院。入院后发生经期咯血,胸部X线片和计算机断层扫描显示右肺上叶前段(S4)区域有结节状阴影。月经几天后,咯血及胸部X线片上的异常阴影消失。根据临床病程、既往史及胸部X线检查结果诊断为肺子宫内膜异位症。在下一次月经期间,再次出现咯血及胸部X线片上右肺上叶前段(S4)区域的结节状阴影,因此进行了经支气管肺活检和腹腔镜检查。经支气管肺活检标本显示有吞噬含铁血黄素的巨噬细胞,腹腔镜检查发现盆腔子宫内膜异位症。给予醋酸布舍瑞林治疗。治疗后经期咯血及胸部X线片上的结节状阴影消失。

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