Cited by 73Pleural and Pulmonary DiseasesEndometriosis Research and TreatmentVenous Thromboembolism Diagnosis and Management

Pneumothorax in Women of Child-Bearing Age

Legras, Antoine, Mansuet-Lupo, Audrey, Rousset-Jablonski, Christine, Bobbio, Antonio, Magdeleinat, Pierre, Roche, Nicolas, Regnard, Jean-François, Gompel, Anne +2 more·2014·Chest

Abstract

Background A significant percentage of pneumothorax in women is due to thoracic endometriosis. Pathophysiologic mechanisms continue to be debated, and pathologic aspects are poorly known.Methods Clinical and pathologic records of all consecutive women of reproductive age operated on for pneumothorax between 2000 and 2011 were retrospectively reviewed.Results Two hundred twenty-nine women (mean age, 33 years) underwent surgery. One hundred forty-four cases (63%) were right-sided, and pneumothoraces were catamenial for 80 women (35%). Diagnosed pelvic endometriosis was associated in 29 cases. At pathology, thoracic endometriosis was diagnosed in 54 cases (24%). Endometrial glands were observed in 33 of 54 cases and were often cystic (16 of 33). Stroma was observed in 51 of 54 cases and endometrial stroma without glands in 21 cases. Hemosiderin-laden macrophages were observed in 27 of 54 cases. All cases of thoracic endometriosis were positive for progesterone and/or estrogen receptors (intense and nuclear). Catamenial pneumothoraces (n = 80, 34.9%) were endometriosis related in 50% of cases (n = 40, 17% of the whole population). Pneumothoraces were noncatamenial but endometriosis related in 6% of cases (n = 14) and merely idiopathic in 60% of patients (n = 135). Multivariate analysis showed that right side, presence of diaphragmatic abnormalities, relapse after unilateral surgery, and presence of hemosiderin-laden macrophages were independent variables associated with thoracic endometriosis (all, P < .02). Apical emphysema-like changes were found in 184 of the 213 patients (86%) with apical resection and were significantly associated with the absence of thoracic endometriosis (P < .001).Conclusions In women with surgically treated pneumothorax, prevalence of catamenial/endometriosis-related pneumothorax is high. Clinicians and pathologists must be aware to recognize such a difficult diagnosis.

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Crossref · 10.1378/chest.13-1284

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  • Pneumothoraces on CXR or CT can be of any size, are typically right-sided (88%-100%), and may result in shifting of the mediastinum.

    “Pneumothoraces on CXR or CT can be of any size, are typically right-sided (88%–100%), and may result in a shifting of the mediastinum.43”
  • 20%-35% of spontaneous pneumothorax in reproductive-aged women are reported to be CP.

    “Regarding frequency, 20%‐35% of spontaneous pneumothorax in reproductive‐aged women are reported to be CP.”

    From Extra-pelvic endometriosis: a review. (2020) · cites this paper as [74]

  • The pneumothorax in catamenial pneumothorax can be of any size and may result in a shifting of the mediastinum.

    “The pneumothorax can be of any size and may result in a shifting of the mediastinum [ 61 ].”

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Authors
Legras, A., Mansuet-Lupo, A., Rousset-Jablonski, C., Bobbio, A., Magdeleinat, P., Roche, N., Regnard, J.-F., Gompel, A., Damotte, D., & Alifano, M.
Affiliations
Hôpital Cochin (FR)
Corresponding author
Alifano, Marco
Venue
Chest
Publisher
Elsevier BV
Published
2014-02
Volume
145
Issue
2
Pages
354-360
ISSN
0012-3692 (ISSN-L)
OpenAlex
W2092693878
Cited by
73
References
24
Citations by year
2026: 4 · 2025: 2 · 2024: 7 · 2023: 7 · 2022: 6 · 2021: 7 · 2020: 8 · 2019: 8 · 2018: 5 · 2017: 2 · 2016: 6 · 2015: 7 · 2014: 2 · 2013: 1 · 2012: 1
FWCI
4.33
Type
journal article
Language
en
Open access
closed
Locations
  • CHEST Journal (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Pleural and Pulmonary Diseases
  • Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
  • Health Sciences › Medicine › Internal Medicine › Venous Thromboembolism Diagnosis and Management
Keywords
pneumothorax, thoracic endometriosis, catamenial pneumothorax, women of child-bearing age, hemosiderin-laden macrophages, endometrial stroma, recurrent pneumothorax, surgical pathology
MeSH terms
Adult, Endometriosis, Female, Hemosiderin, Humans, Macrophages, Pneumothorax, Retrospective Studies, Thoracic Diseases, Prevalence, Multivariate Analysis, Thoracic Surgical Procedures, Pleural Cavity

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