Catamenial pneumothorax pathophysiology

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Endometriosis can attach to the lung, forming chocolate-like cysts. Generally the parietal pleura is involved, but the lung itself, the visceral layer, the diaphragm, and more rarely the tracheobronchial tree may also be afflicted.^[1] How this endometrial tissue reaches the thorax remains enigmatic, although defects in the diaphragm can often be found.^[2]

The cysts can release blood; the endometrial cyst “menstruates” in the lung. Air can move in by an unknown mechanism. The blood and air cause the lung to collapse (i.e. catamenial hemopneumothorax).^[3]

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