Catamenial pneumothorax: a unique radiologic and intraoperative finding

This paper describes a 26-year-old woman with a history of endometriosis who presented with catamenial pneumothorax, investigated using chest X-ray followed by CT and ultimately treated via surgical exploration after a persistent air leak. CT showed a right hydropneumothorax without bullous disease, along with apical pleural nodularity and pleural thickening, and the VATS revealed extensive web-like fibrotic bands in the parietal pleura plus dark nodular areas presumed to be thoracic endometriosis; pleural specimens confirmed endometriosis on pathology. The authors note that CT evidence of the pleural component of catamenial pneumothorax had not previously been described and that fibrous adhesive disease is rare, with the proposed explanation limited by the absence of prior pneumothorax episodes. This paper is centrally about endometriosis — it presents catamenial pneumothorax due to thoracic endometriosis, highlighting distinctive CT and intraoperative pleural findings.

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