[A case of parenchymal pulmonary endometriosis with recurrent chest pain]

A 36-year-old woman was admitted to Nagasaki Citizens Hospital because of severe pleuritic chest pain associated with small amounts of hemoptysis. This episode occurred with the onset of her menses 2 months after a surgical abortion. Chest X-ray revealed a nodular shadow in the left middle lung field. ECG showed no abnormal findings. Pulmonary perfusion scintigram and arteriogram showed no evidence of pulmonary thromboembolism. Over the next 5 years she suffered 5 further episodes of chest pain without hemoptysis, in which every episode coincided with her menses and disappeared within several days after the end of the menses. Chest X-rays disclosed transient nodular shadows on 4 of 6 of the above mentioned episodes. In the earlier episodes one nodular shadow was noted in the left upper lobe S5 a. Later, it was accompanied by an additional nodular shadow in the S5b. Those shadows disappeared in accordance with the diminution of chest pain. From these findings the diagnosis of pulmonary endometriosis was confirmed. Consequently, the antigonadotropin danazol was administered for 6 months. After this, she had no recurrence of her symptoms. Catamenial hemoptysis is usually the most striking symptom of pulmonary endometriosis, which might be an important clue for its diagnosis. The case presented here was characterized by severe chest pain with paucity of hemoptysis.