Summary:
Endometriosis in less common locations can become a diagnostic pitfall both from the clinical and morphological
point of view, as this diagnosis is only seldom considered in the first series of differential diagnoses. This was true
also for our patient reported. 48-year-old woman underwent left superior lobectomy for the clinical diagnosis of
pulmonary neoplasm. Slightly prominent subpleural whitish nodular partly cystic tissue was histologically identified
as pulmonary endometriosis. It consisted of proliferative to hyperproliferative endometrial glands surrounded by
proliferation type stroma. Focally slight cytological glandular atypias and immature squamous metaplasia were
present. Later another focus was located by x-ray examination. Without any surgery, it responded to six month
treatment with competitive gonadoliberin agonist (GnRH analogue) Zoladex. Three years after the treatment no signs
of the disease have been present. The correct clinical diagnosis accompanied with cautious morphological verification
may prevent unnecessary extensive surgery. However, even some correctly diagnosed and morphologically verified
cases may require radical operative removal. Either approach (conservative therapy and surgery) completed with
subsequent dispensarisation may prevent both the common (cycle related progressive tissue damage) and rare (tissue
destruction, malignant transformation) complications.
Key words:
pulmonary endometriosis, lung pseudotumours, long neoplasm, catamenial haemothorax, catamenial
haemoptysis.
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