Intrapulmonary endometriosis is rare thoracic pathology

Aim: To conduct a retrospective analysis of endometrioid thoracic syndrome observed in St. Petersburg hospitals. Matherial and methods. 40 patients with endometrioid thoracic syndrome. The average age was 37±2,7 (from 16 to 61) years. In 11 patients were found to have pulmonary endometriosis. The clinical, laboratory, radiographic and endoscopic data are not possible to establish an accurate diagnosis. Surgery (thoracotomy or VTS) was performed in all cases to verify the diagnosis. The histological preparations were stained with hematoxylin-eosin, Van Gieson, alcian blue. Also, progesterone and estrogen receptors and Ki 67 were detected. Results. In 6 cases the cyst with bloody masses and 5 cases of small foci of hemorrhage in the lung tissue were detected. Endometrial glands sometimes with marked proliferation of epithelium were observed in the lung tissue. In 2 cases the leiomyomatosis hyperplasia was found around endometrial glands. Strong expression of progesterone and estrogen in the epithelium of the glands and cytogenic stroma cells, moderately expressed Ki67 proliferative activity were found. Conclusions. Retrospective analysis allowed to establish some differencial diagnostic signes of pulmonary endometriosis: repeated hemoptysis associated with the menstrual cycle, recurrent pneumothorax, previous operations on the pelvic organs, infertility. However, the main thing in the diagnosis of pulmonary endometriosis belongs histological and immunohistochemical studies and determination of tumor antigen CA 125 in serum.