CTICasesCatamenial Hemoptysis (Thoracic Endometriosis Syndrome)
Imaging findings
Chest CT obtained during menses reveals a focal, ill-defined area of ground-glass opacity with early cystic changes in the anterior segment of the right upper lobe. Bronchoscopy confirms active hemorrhage originating from the right upper lobe bronchus in the absence of any endobronchial lesions, which clinically correlates with recurrent hemoptysis and chest pain tied to the patient's menstrual cycle.
Key takeaways
Thoracic endometriosis syndrome should be strongly considered in premenopausal women presenting with cyclical, menses-associated hemoptysis, chest pain, or pneumothorax. While endometrial implants can be difficult to visualize directly on imaging, the presence of transient, recurrent focal ground-glass opacities representing localized hemorrhage during menstruation is highly characteristic.
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