[A patient with pulmonary endometriosis].
A 30-year-old woman consulted for recent repeated episodes of hemoptysis occurring at the onset of the menses a few months after interruption of estrogen-progesterone treatment. This patient's only surgical history involved uterine curetage. She was a smoker and had cumulated 10 pack-years. Physical examination and chest x-rays were normal. Bronchial endoscopy and cytological examination of the bronchial aspiration were normal. Thoracic CT demonstrated an alveolar image in the right lower lobe. A second CT performed later after resolution of the episode of hemoptysis was normal. Laparoscopy was performed and visualized an endometrial nodule in the pelvis which was removed. The patient's clinical signs disappeared after treatment with triptoreline. Bronchopulmonary endometriosis is an uncommon condition. The main manifestations are catamenial hemoptysis during the first days of the menses. Chest pain is exceptional. Diagnosis may result from an incidental discovery. A traumatic intervention on the uterus is often found in the patient's history. The most commonly proposed pathogenic mechanism involves hematogenic migration following a uterine procedure. Imaging does not disclose specific signs and bronchial endoscopy is often normal but may demonstrate a tracheal or bronchial plaque of endometriosis, or exceptionally endometrial tissue in the endoscopy biopsies. LH-RH agonists remain the current treatment.
L'huillier
J P
JP
Cabinet de Pneumologie, 112, avenue du Bac, 94210 La Varenne-Saint-Hilaire, France. lhuillier.jean-pierre@wanadoo.fr
Salat-Baroux
J
J
D000328:Adult; D004715:Endometriosis / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D005260:Female; D006469:Hemoptysis / Q000209:etiology; D006801:Humans; D010535:Laparoscopy; D008171:Lung Diseases / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D008186:Luteolytic Agents / Q000627:therapeutic use; D008598:Menstruation; D017329:Triptorelin Pamoate / Q000627:therapeutic use; D014599:Uterus / Q000601:surgery
D008186:Luteolytic Agents; D017329:Triptorelin Pamoate