A young woman with regular cycles presents with recurrent right-sided spontaneous pneumothoraces that characteristically occur within 72 hours of onset of menstruation. The MOST likely underlying diagnosis is:
- A Lymphangioleiomyomatosis
- B Thoracic endometriosis syndrome ✓
- C Alpha-1 antitrypsin deficiency
- D Catamenial asthma with barotrauma
Correct answer: B. Thoracic endometriosis syndrome
Explanation
Thoracic endometriosis syndrome causes catamenial pneumothorax, typically right sided, occurring within 24 to 72 hours of menstruation due to diaphragmatic endometrial implants or pleural fenestrations. LAM causes pneumothorax but is unrelated to menses and shows diffuse thin-walled cysts on CT. Alpha-1 antitrypsin deficiency causes basal emphysema. Catamenial asthma is cyclic wheeze without recurrent pneumothorax. Suppression of ovulation is the mainstay of treatment.
Reference: Williams Gynecology, 4th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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