[Imaging findings in catamenial pneumothorax]

Abstract

Objective: To show the presentation and imaging findings of catamenial pneumothorax.

Material and methods: We reviewed the imaging tests (plain-film radiography, computed tomography [CT], magnetic resonance [MR]) performed in six women aged between 28 and 44 years with recurrent pneumothorax associated to menstruation. All patients underwent videothoracoscopic surgery and thoracotomy was necessary in three due to the recurrence of the pneumothorax.

Results: CT was performed in three cases and found pleural nodules in two; one of these was confirmed at MR. Pleural endometriosis was only demonstrated at histological examination in one case. Diaphragmatic blebs and bullae were found in five of the six patients.

Discussion: The most common symptoms of catamenial pneumothorax are chest pain, dyspnea, and hemoptysis. The right side is affected in 90% of cases. The radiological findings are pneumothorax, hemothorax, or hydropneumothorax. CT and MR can help to identify the pleural lesions that are not visible on plain-film radiographs and are a very common finding at surgery.

Conclusion: The diagnosis of catamenial pneumothorax should be suspected in fertile-aged women with a history of recurrent pneumothorax coinciding with menstruation. CT and MR can help to identify lesions suspicious of endometriosis.