Pulmonary endometriosis

Pulmonary endometriosis is manifested as either asymptomatic pulmonary nodules or as pneumothorax, hemothorax, or hemoptysis during menses. We review 84 cases of pulmonary endometriosis in the English literature and report 3 additional patients. One of our patients is the first reported to have hemoneumothorax. Catamenial pneumothorax usually involved the right chest, and occurred in young nulliparous women without pelvic endometrosis. Pleuroscopy, laparoscopy with pneumoperitoneum, and thoracotomy produced a tissue diagnosis infrequently. Hormonal suppression of ovulation and pleurodesis usually corrected this disorder. Catamenial hemothorax only affected the right chest, but occurred in older multiparous women with pelvic endometriosis. While thoracotomy or laparotomy produced a tissue diagnosis, these procedures were not curative. In contrast, our patient with this disorder was treated successfully with pleurectomy. Catamenial hemoptysis occurred in multiparous women without pelvic endometriosis. Bronchoscopy localized bleeding but never produced a tissue diagnosis. Thoracotomy produced endometrial tissue. Endometrial pulmonary nodules require a diagnosis but do not otherwise produce problems.