Objectives: To analyze the clinical data of four
patients with a diagnosis of tracheobronchial endometriosis, and to
reappraise the diagnostic value of bronchoscopy and bronchial brush
cytology in these patients.
conducted a retrospective study of four patients with documented
tracheobronchial endometriosis treated at National Taiwan University
Hospital from 1994 to 1998. The complete histories, diagnostic time
interval, results of physical examinations, laboratory data,
bronchoscopic findings, cytologic results, chest radiographs, and chest
CT of these patients were analyzed.
These patients tend to be younger and nonmultiparous as compared to
other patients with thoracic endometriosis. Bronchoscopic examination
performed within 1 day or 2 days of menses disclosed multiple
purplish-red submucosal patches bilaterally that bled easily when
touched. Cytologic evaluation of the brushing specimens demonstrated
clusters of small cuboid cells consistent with an endometrial origin.
Follow-up bronchoscopic examination in the middle of the menstrual
cycle showed disappearance of the previous tracheobronchial lesions.
The mean diagnostic interval was 3.25 months. All four patients were
successfully treated with danazol therapy.
Conclusions: Tracheobronchial endometriosis consists of a
special subgroup of patients with thoracic endometriosis. Proper timing
of bronchoscopic examination plays an important diagnostic role in
these patients. Cytologic features as well as cyclic changes in
bronchoscopic findings are sufficient to warrant the diagnosis. The
results of treatment with danazol in these patients seemed