月経時喀血を繰り返した肺子宮内膜症の1例  [in Japanese] Pulmonary Endometriosis with Recurrent Catamenial Hemoptysis  [in Japanese]

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Abstract

症例は32歳女性. 31歳時に稽留流産のために子宮内容除去術を受け, その約1年後から月経時に血痰, 喀血が出現するようになった. 胸部X線では月経の度に右中肺野に淡い結節影を認め, 胸部CTでも右S<sup>4</sup>に陰影が確認されたが, 月経時以外には異常はみられなかった. 月経時に行った右S<sup>4</sup>領域結節影の経気管支肺生検では子宮内膜組織を確認できなかったが, ヘモジデリンを貪食したマクロファージが認められた. また, 腹腔鏡検査でも骨盤腔内に stage I (R-AFS分類) の子宮内膜症が確認された. 以上の臨床経過, 既往歴, 画像所見などから肺子宮内膜症と診断した. Buserelin acetate の経鼻噴霧を開始したところ, 月経の抑制と共に血痰は消失し, 胸部X線の異常陰影もみれなくなった.

A 32-year-old woman with a history of dilation and curettage for missed abortion at 31 years old had sudden hemoptysis during menstruation on May 25, 1993. She had catamenial hemoptysis again, and was admitted to our hospital on July 21, 1993. After admission, catamenial hemoptysis occurred, and a nodular shadow was noted in the right S<sub>4</sub> area on chest roentgenogram and computed tomogram. A few days after menstruation, hemoptysis and the abnormal shadow on chest roentgenogram disappeared. Pulmonary endometriosis was diagnosed by clinical course, past history, and chest roentgenographic findigns. During the next menstruation, hemoptysis and a nodular shadow in the right S<sub>4</sub> area on chest roentgenogram recurred, so transbronchial lung biopsy and laparoscopy were done. TBLB specimens revealed macrophages with phagocytosed hemosiderin, and laparoscopy revealed pelvic endometriosis. She was treated with buserelin acetate. Catamenial hemoptysis and the nodular shadow on the chest roentgenogram disappeared after treatment.

Journal

  • The Japanese journal of thoracic diseases

    The Japanese journal of thoracic diseases 33(8), 888-893, 1995-08-25

    The Japanese Respiratory Society

References:  19

Cited by:  3

Codes

  • NII Article ID (NAID)
    10008107817
  • NII NACSIS-CAT ID (NCID)
    AN00187758
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    03011542
  • Data Source
    CJP  CJPref  J-STAGE 
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