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Weekly Chest CasesImaging Conference Cases

Case No : 1

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  • Age/Sex 18 / F
  • Case Title She has been suffered from recurrent hemoptysis with one month interval for last several years. She has no specific past medical history including tuberculosis or other pneumonia.
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Chest PA 1. (9 June 1998)

Diagnosis With Brief Discussion

Imaging Findings
Initial chest radiograph (9 June 1998) shows subtle ground glass opacity in left middle lung zone. HRCT scan (17 June 1998), performed 8 days after initial chest radiograph, shows poorly defined lobular ground glass density in the LLL superior segment, but there is no evidence of bronchiectasis or mass. One month later from chest PA 1, hemoptysis was relapsed. Chest radiograph (8 July 1998) and HRCT (17 May 1998) show similar findings as those of previous attack. In this time, ground glass opacity is denser than previous HRCT and there is another focus of ground glass opacity in the periphery of RLL anterior basal segment.
Reviewy
Bronchopulmonary endometriosis is a disorder of parous women 30 to 50 years of age. There is often a clinical history of several spontaneous deliveries or uterine surgery, and the majority of patients do not have pelvic endometriosis. Generally, postmenopausal patients have no symptom while younger ones have had recurrent hemoptysis at the time of menstruations (catamenial hemoptysis) or 1-3 day before and after. "Catamenial" means monthly in Greek. There is usually a single focus of endometrial tissue in the lung parenchyma and occasionally in an airway, together with a variable amount of parenchymal hemorrhage.
Reference
1. Imaging of Disseases of the Chest, Armstrong P, Wilson AG, Dee P, Hansell DM, second edition, 1995, Mosby, P694
2. Van Schuk PE, Vercauteren SR et al: Catamenial pneumothorax caused by thoracic endometriosis, Ann Thorac Surg, Aug 1996, 62(2) P585-586
3. Espaulella J, Armengol J, et al: Pulmonary endometriosis: conservative treatment with GnRH agonist, Obstet Gynecol, sep 1991,78(3 Pt2) P535-7
4. Cassing PC, Hauser M, Kacl G, et al: Catamenial hemoptysis. Diagnosis with MRI, Chest, May 1997, 111(5) p1447-50
Keywords
Lung, Non-infectious inflammation, Others,
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