Pulmonary Endometriosis

Overview

Endometriosis in less common locations can become a diagnostic pitfall both from the clinical and morphologicalpoint of view, as this diagnosis is only seldom considered in the first series of differential diagnoses. This was truealso for our patient reported. 48-year-old woman underwent left superior lobectomy for the clinical diagnosis ofpulmonary neoplasm. Slightly prominent subpleural whitish nodular partly cystic tissue was histologically identifiedas pulmonary endometriosis. It consisted of proliferative to hyperproliferative endometrial glands surrounded byproliferation type stroma. Focally slight cytological glandular atypias and immature squamous metaplasia werepresent. Later another focus was located by x-ray examination. Without any surgery, it responded to six monthtreatment with competitive gonadoliberin agonist (GnRH analogue) Zoladex. Three years after the treatment no signsof the disease have been present. The correct clinical diagnosis accompanied with cautious morphological verificationmay prevent unnecessary extensive surgery. However, even some correctly diagnosed and morphologically verifiedcases may require radical operative removal. Either approach (conservative therapy and surgery) completed withsubsequent dispensarisation may prevent both the common (cycle related progressive tissue damage) and rare (tissuedestruction, malignant transformation) complications.

Key words:
pulmonary endometriosis, lung pseudotumours, long neoplasm, catamenial haemothorax, catamenialhaemoptysis.