{"paper_id":"f4f03603-fcd7-4f71-a53f-152675af7bc9","body_text":"ECR 2019 / C-2759\nPleural endometriosis: when to suspect?\nCongress:\nECR 2019\nPoster Number:\nC-2759\nType:\nEducational Exhibit\nKeywords:\nEducation and training, Diagnostic procedure, MR, CT, Conventional radiography, Thorax, Respiratory system\nAuthors:\nC. S. Kiebert1, G. O. R. D. Rego1, Y. C. S. Neves2, D. Y. Otto1, L. P. Teixeira1, T. L. Matuki1, R. Guerrini1, M. V. Y. Sawamura1; 1São Paulo/BR, 2Salvador, Ba/BR\nDOI:\n10.26044/ecr2019/C-2759\nLearning objectives\nThe purpose of this Educational Exhibit is to:\nTo summarize the main features of thoracic endometriosis.\nTo review radiological findings of pleural endometriosis in different exams,\nincluding chest radiography (CR),\ncomputed tomography (CT) and magnetic resonance imaging (MRI).\nTo provide tips for radiologists to identify this often unexpected pathology and to help avoid late diagnosis.\nBackground\nEndometriosis is defined as the presence of endometrial tissue outside the uterine cavity.\nThe ectopic tissue is typically located in the pelvis,\nbut endometriosis has been reported in almost all extrapelvic sites.\nThe thoracic cavity is the most frequent extra-abdominopelvic site of endometriosis.\nThe three main theories to explain thoracic endometriosis (TE) are (Figure 1):\ncelomic pleural metaplasia in endometriosis tissue;\nretrograde menses reach the pleural cavity through the peritoneum and diaphragmatic defects; and\nlymphatic or hematogenous embolization of endometrial tissues.\nTEhas a wide variety...\nFindings and procedure details\nRadiological findings of PE:\nChest radiograph (CR):\nUsually the initial exam.\nNormal or nonspecific findings such as:\nPneumothorax;\nPleural effusions; and\nHemopneumothorax.\nComputed tomography (CT):\nHelpful in mapping the lesions and very useful in discarding other diagnoses.\nUsuallydepictsimplants as hypoattenuating nodules sometimes associated with an iso-attenuated component,\ndepending on the size and blood content.\nOther findings include:\nPneumothorax;\nPleural effusions;\nPleural adhesions; and\nIndirect signs of chronic pleural inflammation.\nTemporal changes in the size and morphological appearance of pleural or pulmonary nodules over the menstrual...\nConclusion\nPleural endometriosis is a rare condition and diagnosis can be quite challenging.\nIt should be suspected in women of reproductive age with cyclical chest pain.\nRadiologists should recognize typical imaging findings to avoid a late diagnosis and implement appropriate treatment.\nPersonal information\nCarolina S.\nKiebert (Instituto de Radiologia do Hospital das Clínicas da Universidade de São Paulo,\nSão Paulo,\nBrazil).\nGuilherme O.\nR.\nD.\nRego (Instituto de Radiologia do Hospital das Clínicas da Universidade de São Paulo,\nSão Paulo,\nBrazil).\nYuri C.\nS.\nNeves (Instituto de Radiologia do Hospital das Clínicas da Universidade de São Paulo,\nSão Paulo,\nBrazil).\nDeborah Y.\nOtto (Instituto de Radiologia do Hospital das Clínicas da Universidade de São Paulo,\nSão Paulo,\nBrazil).\nLívia P.\nTeixeira (Instituto de Radiologia do Hospital das Clínicas...\nReferences\nAttaran M,\nFalcone T,\nGoldberg J.\nEndometriosis: still tough to diagnose and treat.\nCleve Clin J Med 2002;69(8):647–653.\nChamie LP,\nRibeiro D,\nTiferes DA,\net al.\nAtypical sites of deeply infiltrative endometriosis: clinical characteristics and imaging findings.\nRadiographics 2018;38:309–28.\nChannabasavaiah AD,\nJoseph JV.\nThoracic endometriosis: revisiting the association between clinical presentation and thoracic pathology based on thoracoscopic findings in 110 patients.\nMedicine 2010;89:183–188.\nRousset P,\nRousset-Jablonski C,\nAlifano M,\nMansuet-Lupo A,\nBuy JN,\nRevel MP.\nThoracic endometriosis syndrome: CT and MRI features.\nClin Radiol 2014;69(3):323-330....","source_license":"CC0","license_restricted":false}