ABSTRACT

We present a case of catamenial pneumothorax in a 48-year-old woman. The patient presented with dyspnea, pleuritic pain and spontaneous pneumothorax, which coincided with the onset of menses. She underwent a right pleurotomy with pleural abrasion of the whole parietal pleura, including the mediastinal pleura. A histological examination showed that the lesion presented sheets of cells resembling endometrial glands and endometrial stroma. Immunohistochemically, the nuclei of the endometrial glands were positive for estrogen and progesterone receptors and stromal cells were strongly positive for CD10. The etiology of catamenial pneumothorax is unclear, however, spontaneous rupture of blebs during hormonal changes, alveolar rupture due to prostaglandin-induced bronchiolar constriction, and sloughing of ectopic endometrial implants in the visceral pleura during menstruation with resultant air leaks have been implicated. Catamenial pneumothorax should be suspected in any woman with pneumothorax and unilateral pain with serohemorrhagic pleural effusion, dyspnea, coughing and recurrent right-sided pneumothorax after the onset of menstruation.

KEYWORDS

Catamenial pneumothorax, endometriosis, immunohistochemical.

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