Pulmonary Endometriosis: A Review

Solwayo Ngwenya*

Pulmonary Endometriosis: A Review.

Endometriosis is a benign gynaecological condition whereby endometrial tissue exists outside
the uterus in women of reproductive age group. It occurs mainly in the pelvis
and rarely extrapelvic areas such as the lungs. Pulmonary endometriosis is a rare but can be life-threatening.

There is active endometrial tissue in the tracheobronchial tree, lung parenchyma and lung
pleura. Pulmonary endometriosis has four main clinical conditions namely catamenial
pneumothorax, catamenial haemothorax, catamenial haemoptysis and
endometrial nodules in the lung.

Catamenial pneumothorax is the most common manifestation. Pulmonary endometriosis is
associated with pelvic endometriosis and subfertility. Because of its rare phenomenon, there
may be delayed diagnosis leading to serious life-threatening complications.

This article aims to raise awareness amongst clinicians particularly
gynaecologists about this rare but life-threatening
condition. It is a benign, treatable condition and no women should die from it.

The aetiological mechanisms of pulmonary endometriosis are
not well known. There are no predisposing factors. A possible explanation
for the pathogenesis may involve peritonealpleural movement of endometrial tissue
through diaphragmatic defects and microembolisation through pelvic veins.

Endometriotic deposits can be found in the diaphragm, pleura, lung
parenchyma and tracheobronchial tree. The preferred
sites are the diaphragm in keeping with the embryological suspected peritoneal-pleural migration route.

Classically there are chest symptoms associated with menstruation. These include dyspnoea,
intermittent productive coughing with blood-tinged sputum, chronic anemia, loss of
appetite, generalised weakness and chest pains. Patients can also present with catamenial
haemoptysis. All these symptoms can be found in patients with pulmonary tubercoloisis.
Some patients may be asymptomatic.

Pulm Res Respir Med Open J. 2016; 3(2): 30-32. doi: 10.17140/PRRMOJ-3-128