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Cho, Kim, Kim, Park, Lee, Jang, Jung, Jun, and Lee: Catamenial Hemoptysis Treated by Video-assisted Thoracoscopic Surgery
Case Report
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2008; 65(1): 29-33.

Published online: 31 July 2008

DOI: https://doi.org/10.4046/trd.2008.65.1.29

Catamenial Hemoptysis Treated by Video-assisted Thoracoscopic Surgery

Chang Beom Cho, M.D.1, Dong-Gyu Kim, M.D.1, Changhwan Kim, M.D.1, Ji Young Park, M.D.1, Seok Won Lee, M.D.1, Seung Hun Jang, M.D.1, Ki-Suck Jung, M.D.1, Sun-Young Jun, M.D.2, Jae Woong Lee, M.D.3

1Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea.

2Department of Pathology, Hallym University College of Medicine, Chuncheon, Korea.

3Department of Thoracic and Cardiovascular Surgery, Hallym University College of Medicine, Chuncheon, Korea.

Address for correspondence: Dong-Gyu Kim, M.D. Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Sacred Heart Hospital, 896, Pyeongchon-dong, Dongan-gu, Anyang 431-070, Korea. Phone: 82-31-380-3715, Fax: 82-31-381-3973, dongyu@hallym.ac.kr

Received 8 July 2008       Accepted 14 July 2008

Copyright © 2008 The Korean Academy of Tuberculosis and Respiratory Diseases

Abstract

Catamenial hemoptysis is a rare condition that's characterized by recurrent hemoptysis occurring in association with menstruation, and this is associated with the presence of intrapulmonary or endobronchial endometrial tissue. The diagnosis of pulmonary endometriosis can be made according to a typical clinical history and with exclusion of other causes of recurrent hemoptysis. Treatment of pulmonary endometriosis can be medical or surgical; however, the optimal management of this condition is still a matter of debate. Medical therapy may be problematic, due to recurrence of symptoms despite hormonal ablation, and adverse effects from long-term hormone therapy can also be a problem. We report here on a case of pulmonary endometriosis in a 23-year-old woman who presented with hemoptysis that occurred during the first 3 days of menstruation, and this happened over a 4 month period. She was successfully treated by video-assisted thoracoscopic surgery (VATS). No more hemoptysis was noted during 12 months of follow-up.

Keywords: Catamenial hemoptysis, Pulmonary endometriosis, Video-assisted thoracoscopic surgery (VATS)

Figures and Tables

Figure 1
Preoperative chest x-ray shows no abnormal finding.
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Figure 2
A chest HRCT image obtained during the patient's menstrual period shows consolidation and ground glass opacity at the lateral and posterior basal segment of right lower lobe (A). 2 months later, the other chest CT image shows aggravation of consolidation and ground glass opacity at the same segments (B).
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Figure 3
Engorged blood vessels were noted in the right lower lobar bronchus (A). 2 months later, a small amount of fresh blood was coming out from the basal segment of the right lower lobe (B, C).
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Figure 4
A lobectomy specimen of right lower lung, measuring 15×10×5 cm, reveals a pooly-demarcated hemorrhagic mass (4×3.5×1.5 cm), 10 cm apart from the bronchial resection margin (A). Microscopically, there is extensive intraalveolar hemorrhage with congested dilated vessels (H&E stain, ×40) (B). In the hemorrhagic alveolar spaces, many hemosiderin-laden macrophages (arrows) are seen (H&E stain, ×400) (C).
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