2014 Volume 28 Issue 7 Pages 937-944
A 17-year-old woman experienced sudden hemoptysis during menstruation 6 months after intrauterine curettage. She came to our hospital because of repeated catamenial hemoptysis during each menstruation period. Chest CT revealed infiltrative shadows around S9 of the right lung. Bronchoscopic examination revealed hemorrhage from the right B9. Thus, pulmonary endometriosis with the responsible lesion in S9 was suspected. Hormone therapy was effective to improve her hemoptysis. However, she desired to return to regular school life to improve future employment prospects,with withdrawal from hormonal agents. Thus, surgical therapy was performed for radical therapy resecting ectopic endometrial tissue. A lesion was identified as the hemorrhage site showing change under the visceral pleura via a thoracoscope. Although mild adhesion after inflammation was noted, right lower lobectomy appeared feasible and was completed in endosurgery. A lesion was diagnosed as pulmonary endometriosis by histological confirmation of an ectopic endometrial gland and endometrial stromal tissue in the resected lung. On immunohistochemical examination, endometrial gland cells stained positively for ER and PgR, whereas endometrial stromal cells stained positively for CD10, ER, and PgR. The postoperative course was uneventful. The patient has been asymptomatic for 3 years since surgery. Pulmonary endometriosis is rare, comprising one sixth of pleural endometriosis cases. Furthermore, histological confirmation like in this case is rare. The role of endosurgery is considered important in this disease.