Red flags for thoracic endometriosis

This case report describes a 38-year-old Brazilian woman with dyspnea, chest pain, and dry cough, whose CT showed a right basal pleural effusion and who had a positive QuantiFERON-TB test, initially leading to suspicion of pleural tuberculosis. Thoracentesis yielded hemorrhagic pleural fluid with cytology showing histiocytes and leukocytes and no malignant cells; medical thoracoscopy then found thickened pleura with small wine-red lesions on the diaphragm and parietal pleura. Histopathology confirmed pleural endometriosis with epithelial glandular elements and immunohistochemical positivity for CD10 and estrogen receptors, while the report notes the main challenge is the nonspecific thoracic symptom presentation that can make diagnosis difficult. This paper is centrally about endometriosis — it presents a thoracic endometriosis case with diagnostic findings in pleural/diaphragmatic lesions.

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