A 33-year-old nulliparous woman has recurrent episodes of shortness of breath and right-sided chest pain that occur exclusively within 48 hours of the onset of menstruation. Chest imaging shows a small right pneumothorax each time. Video-assisted thoracoscopic surgery reveals reddish-brown pleural lesions. What is the underlying diagnosis?
- A Lymphangioleiomyomatosis
- B Catamenial angina from coronary vasospasm
- C Thoracic endometriosis syndrome ✓
- D Recurrent spontaneous pneumothorax due to blebs
Correct answer: C. Thoracic endometriosis syndrome
Explanation
Catamenial pneumothorax is the commonest manifestation of thoracic endometriosis syndrome, characteristically right-sided and timed to menses, caused by ectopic endometrial tissue on the diaphragm and pleura. Simple apical blebs cause pneumothorax unrelated to the menstrual cycle, lymphangioleiomyomatosis occurs almost exclusively in tuberous sclerosis or sporadic settings with progressive cysts, and coronary vasospasm does not produce recurrent pneumothoraces.
Reference: Williams Gynecology, 4th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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