Catamenial Pneumothorax
Living With Lung and Colon Endometriosis
History

                                                   
                                                                                                                                                                                                                        
                                                                                                       
                                                            

                             

                                   History of Lung Endometriosis 
                             Catamenial Pneumothorax

The first reported cases of this disease were in the 1930’s. Menstrual bleeding from a lung tumor associated with endometriosis was by Schwarz in 1938. A laboratory investigation by Hobbs and Bortnick in 1940 was able to produce pulmonary endometriosis in rabbits by intravenous infusion of endometrial tissue suspension. Bungeler and associates in 1939 reported autopsy findings of three small nodules of endometriosis on the right upper pleural surface in a 42-year-old woman. Nicholson in 1951 was the first to report histologically proven endometriosis in a clinical case of recurrent hemorrhagic pleural effusion. Many cases of endometriosis have been reported within the thorax in various sites: lung parenchyma, pleura, diaphragm, myocardium and bronchial tree. This has been referred to as Thoracic, Pulmonary, Extrapelvic and Lung Endometriosis. This disease is considered to be extremely rare, but actually it is, under recognized and under diagnosed.

Pioneers of Thoracic Endometriosis

                                                                                                 Abdominal
Author                      Year  Age  Parity  Location   Symptoms                  Proof             Endometriosis

Pleural
     Bungeler et al.        1939      42        -         Right         None, autopsy material       Microscopic           --
     Nicholson               1951      23       0         Right         Hemothorax, recurrent        Microscopic          Yes
     Charles                  1957      33       0         Right         Hemothorax, recurrent        None                    Yes
     Ripstein et al.         1959      24       0         Right         Hemothorax, recurrent        Microscopic          Yes
     Williams et al.        1962      26       0         Right         Hemothorax                       None                    Yes
Diaphragmatic 
     Brews                    1954      39        -         Right         Pleural effusion, ascites      Microscopic          Yes
     Maurer et al.           1958      35        -         Right         Pneumothorax                   Microscopic          Yes
     Skobel                   1963      39        1         Right         Hemothorax                      Microscopic          Yes
     McSwain et al        1964       30        -         Right         Pneumothorax, recurrent      --                        Yes
Pulmonary
     Schwarz                 1938       -           -          -             Hemoptysis cyclic               None                    --
     Lattes et al.            1956      34         2        Right         Hemoptysis during menses  Microscopic         No
     Fleishman et al.      1959      39         2        Left           Hemoptysis during menses  Radiologic            No
     Sturzennegger        1960      52         -         Right         None, x-ray finding              Microscopic          --
     Mobbs et al.           1963      31         2        Right         None, x-ray finding              Microscopic           
     Kishkovsky etal      1963      34         2        Right         Hemoptysis during menses  Radiologic            --
Bronchial
     Rodman et al.         1962      26       1Ab     Left           Hemoptysis during menses  Microscopic          --
Myocardial
     Felson et al.            1960     46        -          RV           Pleural effusion                   Microscopic Adenomyosis
   

Definitions:

Catamenial pneumothorax: 
A condition of collapsed lung occurring in conjunction with menstrual
     periods (catamenial refers to menstruation), believed to be caused primarily by endometriosis of the
     pleura (the membrane surrounding the lung).
Catamenial Hemopneumothorax:  When endometrial cells attaches to the lung release blood which
     accumulates to large levels, and air moves in through fenestrations in the diaphragm by an unknown
     mechanism causing the lung to collapse.
Catamenial Hemothorax:  The accumulation of blood without lung collapse.
Catamenial Hemoptysis: Coughing up blood from the respiratory tract during menstruation because of
     intrathoracic endometriosis. Endometrial cells have moved into the tracheo-bronchial tree