Dear Friends,
An easy case to get ready for summer vacation. Images belong to a 43-year-old woman with recurrent episodes of chest pain. What would be your diagnosis?
Check the images below, leave your thoughts in the comments section and come back on Friday for the answer.
Click here for the answer to case #118
Findings: PA chests in 2010, 2012 (not shown) and 2013 show a right pneumothorax (A-B, arrows) with the typical “V line at the base (A-B, red arrows).
The patient had painful menses and the pneumothoraxes coincided with the menstruation. Abdominal surgery found pelvic endometriosis. MRI of the chest demonstrated an area of high signal intensity in the pleura (C-D, arrows) compatible with pleural endometriosis.
Final diagnosis: catamenial pneumothorax
Congratulations to Genchi Bari who was the first to suggest the diagnosis, followed by Alberto Montemayor five hours later.
Teaching point: recurrent pneumothorax has many etiologies; when occurring on the right side in a fertile woman, endometriosis should be considered as a probable cause.
