A 33-year-old woman has recurrent episodes of right-sided chest pain and breathlessness occurring exclusively during menstruation for the past 2 years. Chest radiograph during an episode shows a small right pneumothorax. Between menses she is asymptomatic and imaging is normal. What is the most likely diagnosis?
- A Pulmonary tuberculosis
- B Spontaneous pneumothorax due to bleb rupture
- C Catamenial pneumothorax due to thoracic endometriosis ✓
- D Lymphangioleiomyomatosis
Correct answer: C. Catamenial pneumothorax due to thoracic endometriosis
Explanation
Thoracic endometriosis syndrome presents as catamenial pneumothorax, classically right-sided and recurring within 72 hours of onset of menses. It is attributed to diaphragmatic defects or transcoelomic spread of endometrial tissue. Bleb-related spontaneous pneumothorax is not cyclically linked to menstruation, tuberculosis gives persistent infiltrates rather than purely cyclical events, and lymphangioleiomyomatosis causes progressive diffuse cystic lung disease, not isolated menstrual episodes.
Reference: Berek and Novak's Gynecology, 16th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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