Hasan BAYRAM, Şermin BÖREKÇİ, Kemal BAKIR, Osman ELBEK, Öner DİKENSOY, Ebru DİKENSOY, Yasemin KİBAR

Catamenial hemoptysis

Nadir gözlenen bir patoloji olan katameniyal hemoptizi intrapulmoner ya da endobronşiyal alanlarda endometriyum dokusunun varlığıyla karakterizedir. Bu makalede endobronşiyal tutulum ile seyreden katameniyal hemoptizili bir olgu sunulmuştur. Yirmi iki yaşındaki hastanın öyküsünde son iki yıldır menstrüel siklus döneminde tekrarlayan hemoptizi epizodları mevcuttu. Menstrüasyonun ilk gününde yapılan bronkoskopik incelemesinde trakea 1/3 distalinde ve her iki bronş sisteminde, dokunmakla kolayca kanayan, pembe-kırmızı/vişne çürüğü renkte yama tarzında alanlar izlendi. Bu bölgelerden yapılan bronşiyal fırçalama örneklemesinin sitolojik incelemesinde endometriyum orjinli küçük küboidal hücrelerin oluşturduğu hücre grupları saptandı. Menstrüasyonun bitiminden sonra tekrarlanan bronkoskopik incelemede ise ilk bronkoskopide tespit edilen tüm lezyonların kaybolduğu görüldü. Hastaya gonadotropin-salgılatan hormon analoğu ile östrojen ve progesteron içeren hormon replasman tedavisi başlandı. Tedavi ile tam yanıt alındı.

Katameniyal hemoptizi

Catamenial hemoptysis is a rare condition that is associated with the presence of intrapulmonary or endobronchial endometrial tissue. We describe a case of endobronchial endometriosis with catamenial hemoptysis. The patient was a 22 years-old girl presented with recurrent hemoptysis episodes for the last two years. Bronchoscopic examination was performed within first days of menses, and indicated multiple purplish-red submucosal patches in distal one third of trachea and bilateral bronchial trees that bled easily when touched. The cytological evaluation of the bronchial brushing specimens demonstrated clusters of small cuboidal cells consistent with an endometrial origin. Follow-up bronchoscopic examination at the end of the menstrual cycle revealed that the previous tracheobronchial lesions disappeared. The patient was treated with Gonadotropin-Releasing Hormone (GnRH) analogues and hormones including estrogen and progesterone therapy. Recurrent hemoptysis stopped following the medical treatment.

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