Thoracic endometriosis: clinicopathologic updates and issues about 18 cases from a tertiary referring center

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• 作者：Maria-Rosa Ghigna ; MD^a ; ^{mr.ghigna@ccml.fr" class="auth_mail" title="E-mail the corresponding author} ; Olaf Mercier ; MD ; PhD^b ; ^{o.mercier@ccml.fr" class="auth_mail" title="E-mail the corresponding author} ; Sacha Mussot ; MD^b ; ^{s.mussot@ccml.fr" class="auth_mail" title="E-mail the corresponding author} ; Dominique Fabre ; MD^b ; ^{d.fabre@ccml.fr" class="auth_mail" title="E-mail the corresponding author} ; Elie Fadel ; MD ; PhD^b ; ^{e.fadel@ccml.fr" class="auth_mail" title="E-mail the corresponding author} ; Peter Dorfmuller ; MD ; PhD^a ; ^{p.dorfmuller@ccml.fr" class="auth_mail" title="E-mail the corresponding author} ; Vincent Thomas de Montpreville ; MD^a ; ^{v.thomasdemontprevil@ccml.fr" class="auth_mail" title="E-mail the corresponding author}
• 关键词：PNX ; pneumothorax ; CT ; computed tomography ; LAM ; lymphangioleiomyomatosis ; BHD syndrome ; Birt-Hogg-Dubé ; syndrome
• 刊名：Annals of Diagnostic Pathology
• 出版年：2015
• 出版时间：October 2015
• 年：2015
• 卷：19
• 期：5
• 页码：320-325
• 全文大小：1803 K

文摘

Thoracic endometriosis is defined as the ectopic presence of endometrial glands and stroma in lung or pleura and constitutes an uncommon cause of spontaneous pneumothorax in nonsmoker women in childbearing age. From 2000 to 2014, 18 (7.3%) women of 246 had a histologically proven endometriosis-related pneumothorax. The examination of thoracic samples was performed on formalin-fixed, paraffin-embedded hematoxylin and eosin–stained slides. Immunohistochemistry was carried out on all samples. The pathologic findings included endometriosis foci appearing as a triad of endometrial glands, stroma, and hemosiderin-laden macrophages in 8 patients. In the remaining 10 patients, minute nests of endometrial stroma were recognized at histologic examination and immunohistochemistry. One patient displayed diaphragmatic endometriosis and pulmonary lymphangioleiomyomatosis. Thoracic endometriosis is an uncommon cause of recurrent pneumothorax necessitating histologic confirmation. The histologic diagnosis of endometriosis may be challenging on small pleural or lung biopsies because endometriosis mostly appears as minute nests of endometrial stromal cells. Here, we present our experience on thoracic endometriosis: considering frequent interpretation difficulties of biopsy samples, we propose a multidisciplinary diagnostic algorithm.