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Weekly Chest CasesArchive of Old Cases

Case No : 792 Date 2012-12-31

  • Courtesy of Song Soo Kim, MD / Chungnam National University College of Medicine
  • Age/Sex 29 / F
  • Chief ComplaintHemoptysis
  • Figure 1
  • Figure 2
  • Figure 3
  • Figure 4

Figure 1.

Diagnosis With Brief Discussion

Diagnosis
Catamenial hemorrhage
Radiologic Findings
HRCT scans show regional ill defined nodules with GGO in lateral basal segment of RLL.
Chest PA shows patchy GGO in RMLZ.Two weeks later, Chest PA shows disappearance of previous patchy GGO in RMLZ.
Brief Review
Thoracic endometriosis
1> Pleural - catamenial pneumothorax or hemothorax with chest pain and dyspnea
2> Parenchymal - microembolism of endometrial tissue,
3> Clinical problems
- Usually 20-30 yrs old female
- Usually develop within 72 hr of the onset of menstruation
4> CT findings
- Ill-defined opacities (several cm in size)
- Nodules
- Area of consolidation surrounding nodules
- Thin-walled cavities
- Bullae
- Lesions vary in size during the menstrual cycle and disappear after the cessation of menstruation
5> Pathologic feature: Various stage of pulmonary hemorrhage
- Nodule: localized pulmonary hematoma
- Cavitary nodule or bullae: hematoma in which the content had partly or completely emptied
- GGO: parenchymal hemorrhage that was partaly fiiling alveoli
- Consolidation: organizing pneumonia with hemosiderin-laden macrophage or pulmonary hemorrhage completely filling alveoli
- Bandlike opacity: linear fibrosis resultant from chronic hemorrhage
6> Tx. Hormone Tx. (GnRH agonist), surgical resection
Please refer to
Case 251, Case 558,
KSTR Symposium 1998  Case 1,
References
Lee YR, Choi YW, Jeon SC, Paik SS, Kang JH. On the AJR viewbox. Pleuropulmonary endometriosis: CT-pathologic correlation. AJR Am J Roentgenol 2006; 186:1800-1801.
Keywords
lung, embolic,

No. of Applicants : 90

▶ Correct Answer : 47/90,  52.2%
  • - NIMS, HYDERABAD , India bhaskar kakarla
  • - Onomichi municipal hospital , Japan Hirofumi Mifune
  • - Chungnam National University hospital , Korea (South) sunkyoung you
  • - Onomichi Municipal Hospital , Japan Yoshihisa Masaoka
  • - UWO , Canada S Lee
  • - Dae-Jeon Bohun Veterans Hospital , Korea (South) KI-TAE HAN
  • - Gyeongsang National Universit Hospital , Korea (South) Sung Park
  • - China Medical University , China zhang wei
  • - SNUH , Korea (South) Euijin Hwang
  • - Samsung medical center , Korea (South) Hyun Su Kim
  • - Samsung medical center , Korea (South) Min Jae Cha
  • - , Korea (South) Sanghyuk Ahn
  • - Joeun Kumgang hospital , Korea (South) Ji Eun Seok
  • - GOLD child and chest clinic tirunelvelli , India saravanan m
  • - CHU Saint Pierre , Belgium Abd Alla Fares
  • - Fukuyama city hospital , Japan Ryotaro Kishi
  • - chp st martin , France Mariotte benoit
  • - Radnet Teleradiology Istanbul , Turkey Armagan Sarac
  • - Kyung Hee University Medical center , Korea (North) Myung You
  • - Medical College Chest Hospital,Thrissur,Kerala , India Raveendran TK
  • - Asan Medical Center , Korea (South) Sang Min Lee
  • - Asan medical center , Korea (South) Sang Young Oh
  • - Himeji St.Mary Hospital , Japan Yuichiro Kanie
  • - Asan medical center , Korea (South) Hyun Joo Lee
  • - Asan Medical Center , Korea (South) Hye Jeon Hwang
  • - Asan Medical Center, Ulsan University , Korea (South) Mi Young Kim
  • - Asan medical center , Korea (South) Kichang Han
  • - Hangang Sacred Heart Hospital , Korea (South) Eil Seong Lee
  • - Hanyang Medical Center , Korea (South) KIBO YOON
  • - Institute of Liver and Biliary Sciences , India Ankur Dev
  • - Institute of Liver & Biliary Sciences , India Ankur Arora
  • - Konkuk University Medical Center , Korea (South) Inyoung Song
  • - China Medical University , Ditmanson Medical Foundation Chia-Yi Christian Hospital ,Taiwan, R.O.C. , Taiwan Jun Jun Yeh
  • - HIA Legouest - METZ , France Alban Gervaise
  • - Dongnam Institute of Radiological and Medical Sciences , Korea (South) Dae-Wook Yeh
  • - Asan Medical Center , Korea (South) Eunyoung Kim
  • - IRSA La Rochelle France , France Denis Chabassiere
  • - Gangnam Severance Hospital , Korea (South) Chul Hwan Park
  • - Saint Malo , France jean-baptiste Noel
  • - IRCCS Istituto Oncologico - Bari , Italy Carlo Florio
  • - Okayama University , Japan Satoko Kogawa
  • - All India Institute of medical sciences , India Justin Moses
  • - H�pital du Sacr , Canada Andrea Ojanguren
  • - Kohka Public Hospital , Japan Akitoshi Inoue
  • - Radiology department, Sanggye Paik Hospital, Seoul, Republic of Korea , Korea (South) Dongheon Yeom
  • - Kyungpook National University Hospital , Korea (South) Jaekwang Lim
  • - All India Institute of Medical Sciences , India Ashish Gupta
▶ Correct Answer as Differential Diagnosis : 4/90,  4.4%
  • - Kyung Hee Universitiy Hospital at Gangdong , Korea (South) Seong Jong Yun
  • - XiangYa hospital , China Xia Yu
  • - GHICL , France manuel toledano
  • - Teikyo mizonokuchi hospital , Japan Takana Yamakawa
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