胸腔子宫内膜异位症致血性胸腔积液一例并文献复习_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

冯银合 ^1,2 , 杨晓娅 ¹ , 曾春芳 ² ,  毛辉 ¹

1. ;
2. ;

Corresponding author：

毛辉, Email: merrymh@126.com

Keywords：

子宫内膜异位症; 胸腔子宫内膜异位症; 胸腔积液

DOI：

10.7507/1671-6205.202102025

Video：

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目的拓展血性胸腔积液的鉴别诊断范畴，加深临床医师对胸腔子宫内膜异位症的认识，为其诊断、治疗提供有价值的参考。方法报道1例罕见的胸腔子宫内膜异位症致血性胸腔积液患者的诊治经过，并在PubMed数据库以胸腔子宫内膜异位症为关键词进行文献检索予以文献复习。结果该患者血性胸腔积液于外院初诊为癌性胸腔积液，入院后经胸腔镜获取病理组织行病理活检和免疫组织化后明确诊断为胸腔子宫内膜异位症，通过胸腔置管引流及促性腺激素释放激素类似物治疗后目前随访3个月暂未见复发。检索相关文献发现，胸腔子宫内膜异位症导致血性胸腔积液患者临床罕见，发病机制不明确，缺乏特异的症状及影像学特征，其诊断需基于临床表现、影像学及病理活检，治疗需依据病情合理选择药物及手术，但该病复发率较高。结论胸腔子宫内膜异位症为胸腔积液的罕见病因，需加深对其认识避免误诊及漏诊，对于症状与月经周期存在时间关系、右侧胸腔病变、育龄期女性、病情反复的患者临床需谨慎排除。

Citation： 冯银合, 杨晓娅, 曾春芳, 毛辉. 胸腔子宫内膜异位症致血性胸腔积液一例并文献复习. Chinese Journal of Respiratory and Critical Care Medicine, 2021, 20(10): 734-737. doi: 10.7507/1671-6205.202102025 Copy

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2.	Nezhat C, Li A, Abed S, et al. Strong association between endometriosis and symptomatic leiomyomas. JSLS, 2016, 20(3): e2016.00053.
3.	Yukumi S, Suzuki H, Morimoto M, et al. A case of thoracic endometriosis-related pneumothorax in a menopausal woman. Gen Thorac Cardiovasc Surg, 2020, 68(12): 1584-1586.
4.	Nezhat C, Li A, Falik R, et al. Bowel endometriosis: diagnosis and management. Am J Obstet Gynecol, 2018, 218(6): 549-562.
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9.	Andres MP, Arcoverde F, Souza C, et al. Extrapelvic endometriosis: a systematic review. J Minim Invasive Gynecol, 2020, 27(2): 373-389.
10.	Legras A, Mansuet-Lupo A, Rousset-Jablonski C, et al. Pneumothorax in women of child-bearing age: an update classification based on clinical and pathologic findings. Chest, 2014, 145(2): 354-360.
11.	Rousset P, Rousset-Jablonski C, Alifano M, et al. Thoracic endometriosis syndrome: CT and MRI features. Clin Radiol, 2014, 69(3): 323-330.
12.	Rousset P, Gregory J, Rousset-Jablonski C, et al. MR diagnosis of diaphragmatic endometriosis. Eur Radiol, 2016, 26(11): 3968-3977.
13.	McCann MR, Schenk WB, Nassar A, et al. Thoracic endometriosis presenting as a catamenial hemothorax with discordant video-assisted thoracoscopic surgery. Radiol Case Rep, 2020, 15(9): 1419-1422.
14.	Korom S, Canyurt H, Missbach A, et al. Catamenial pneumothorax revisited: clinical approach and systematic review of the literature. J Thorac Cardiovasc Surg, 2004, 128(4): 502-508.
15.	Sun H, Fukuda S, Hirata T, et al. IFITM1 is a novel, highly sensitive marker for endometriotic stromal cells in ovarian and extragenital endometriosis. Reprod Sci, 2020, 27(8): 1595-1601.
16.	Mataca E, Rossi G, Colby TV. The helpful role of CD10 and hormonal receptors co-expression in the histologic diagnosis of catamenial pneumothorax. Int J Surg Pathol, 2019, 27(6): 593-597.
17.	Arakawa T, Fukuda S, Hirata T, et al. PAX8: a highly sensitive marker for the glands in extragenital endometriosis. Reprod Sci, 2020, 27(8): 1580-1586.
18.	Mecha E, Makunja R, Maoga JB, et al. The importance of stromal endometriosis in thoracic endometriosis. Cells, 2021, 10(1): 180.
19.	Azizad-Pinto P, Clarke D. Thoracic endometriosis syndrome: case report and review of the literature. Perm J, 2014, 18(3): 61-65.
20.	Marshall MB, Ahmed Z, Kucharczuk JC, et al. Catamenial pneumothorax: optimal hormonal and surgical management. Eur J Cardiothorac Surg, 2005, 27(4): 662-666.
21.	Zhen Q, Xu Y, Li Q, et al. Thoracic endometriosis with catamenial hemoptysis and hemothorax: long-term follow-up after GnRH-a treatment. J Thorac Oncol, 2019, 14(11): e253-e257.
22.	Lee HT, Wang HC, IaT H, et al. Endometriosis associated with hemothorax. J Chin Med Assoc, 2006, 69(1): 42-46.
23.	Sharma N, Todhe P, Ochieng P, et al. Refractory thoracic endometriosis. BMJ Case Rep, 2020, 13(8): e235965.
24.	Ciriaco P, Muriana P, Lembo R, et al. Treatment of thoracic endometriosis syndrome: a meta-analysis and review. Ann Thorac Surg, 2020, 4975(20): 32117.
25.	Fukuda S, Hirata T, Neriishi K, et al. Thoracic endometriosis syndrome: comparison between catamenial pneumothorax or endometriosis-related pneumothorax and catamenial hemoptysis. Eur J Obstet Gynecol Reprod Biol, 2018, 225: 118-123.
26.	马玉燕, 潘钰, 高晓东, 等. 肺子宫内膜异位症4例报告并文献复习. 中国临床医学杂志, 2018, 25(3): 498-502.

1. Nezhat C, Lindheim SR, Backhus L, et al. Thoracic endometriosis syndrome: a review of diagnosis and management. JSLS, 2019, 23(3): e2019.00029.
2. Nezhat C, Li A, Abed S, et al. Strong association between endometriosis and symptomatic leiomyomas. JSLS, 2016, 20(3): e2016.00053.
3. Yukumi S, Suzuki H, Morimoto M, et al. A case of thoracic endometriosis-related pneumothorax in a menopausal woman. Gen Thorac Cardiovasc Surg, 2020, 68(12): 1584-1586.
4. Nezhat C, Li A, Falik R, et al. Bowel endometriosis: diagnosis and management. Am J Obstet Gynecol, 2018, 218(6): 549-562.
5. Yovich JL, Rowlands PK, Lingham S, et al. Pathogenesis of endometriosis: look no further than John Sampson. Reprod Biomed Online, 2020, 40(1): 7-11.
6. Lutz K, Raimund D, Kumar KP, et al. Endometriosis in MRKH cases as a proof for the coelomic metaplasia hypothesis. Reproduction (Cambridge, England), 2019, 158(2): R41-R47.
7. Konrad L, Dietze R, Riaz MA, et al. Epithelial-mesenchymal transition in endometriosis-when does it happen. J Clin Med, 2020, 9(6): 1915.
8. Hirata T, Koga K, Osuga Y. Extra-pelvic endometriosis: a review. Reprod Med Biol, 2020, 19(4): 323-333.
9. Andres MP, Arcoverde F, Souza C, et al. Extrapelvic endometriosis: a systematic review. J Minim Invasive Gynecol, 2020, 27(2): 373-389.
10. Legras A, Mansuet-Lupo A, Rousset-Jablonski C, et al. Pneumothorax in women of child-bearing age: an update classification based on clinical and pathologic findings. Chest, 2014, 145(2): 354-360.
11. Rousset P, Rousset-Jablonski C, Alifano M, et al. Thoracic endometriosis syndrome: CT and MRI features. Clin Radiol, 2014, 69(3): 323-330.
12. Rousset P, Gregory J, Rousset-Jablonski C, et al. MR diagnosis of diaphragmatic endometriosis. Eur Radiol, 2016, 26(11): 3968-3977.
13. McCann MR, Schenk WB, Nassar A, et al. Thoracic endometriosis presenting as a catamenial hemothorax with discordant video-assisted thoracoscopic surgery. Radiol Case Rep, 2020, 15(9): 1419-1422.
14. Korom S, Canyurt H, Missbach A, et al. Catamenial pneumothorax revisited: clinical approach and systematic review of the literature. J Thorac Cardiovasc Surg, 2004, 128(4): 502-508.
15. Sun H, Fukuda S, Hirata T, et al. IFITM1 is a novel, highly sensitive marker for endometriotic stromal cells in ovarian and extragenital endometriosis. Reprod Sci, 2020, 27(8): 1595-1601.
16. Mataca E, Rossi G, Colby TV. The helpful role of CD10 and hormonal receptors co-expression in the histologic diagnosis of catamenial pneumothorax. Int J Surg Pathol, 2019, 27(6): 593-597.
17. Arakawa T, Fukuda S, Hirata T, et al. PAX8: a highly sensitive marker for the glands in extragenital endometriosis. Reprod Sci, 2020, 27(8): 1580-1586.
18. Mecha E, Makunja R, Maoga JB, et al. The importance of stromal endometriosis in thoracic endometriosis. Cells, 2021, 10(1): 180.
19. Azizad-Pinto P, Clarke D. Thoracic endometriosis syndrome: case report and review of the literature. Perm J, 2014, 18(3): 61-65.
20. Marshall MB, Ahmed Z, Kucharczuk JC, et al. Catamenial pneumothorax: optimal hormonal and surgical management. Eur J Cardiothorac Surg, 2005, 27(4): 662-666.
21. Zhen Q, Xu Y, Li Q, et al. Thoracic endometriosis with catamenial hemoptysis and hemothorax: long-term follow-up after GnRH-a treatment. J Thorac Oncol, 2019, 14(11): e253-e257.
22. Lee HT, Wang HC, IaT H, et al. Endometriosis associated with hemothorax. J Chin Med Assoc, 2006, 69(1): 42-46.
23. Sharma N, Todhe P, Ochieng P, et al. Refractory thoracic endometriosis. BMJ Case Rep, 2020, 13(8): e235965.
24. Ciriaco P, Muriana P, Lembo R, et al. Treatment of thoracic endometriosis syndrome: a meta-analysis and review. Ann Thorac Surg, 2020, 4975(20): 32117.
25. Fukuda S, Hirata T, Neriishi K, et al. Thoracic endometriosis syndrome: comparison between catamenial pneumothorax or endometriosis-related pneumothorax and catamenial hemoptysis. Eur J Obstet Gynecol Reprod Biol, 2018, 225: 118-123.
26. 马玉燕, 潘钰, 高晓东, 等. 肺子宫内膜异位症4例报告并文献复习. 中国临床医学杂志, 2018, 25(3): 498-502.

Chinese Journal of Respiratory and Critical Care Medicine

胸腔子宫内膜异位症致血性胸腔积液一例并文献复习

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