Clinical and Pathological Characteristics of Spontaneous Pneumothorax in Women: a 25-year Single-institutional Experience

Overview

Journal Gen Thorac Cardiovasc Surg

Specialties Cardiology & Vascular Diseases
General Surgery
Pulmonary Medicine

Date 2018 May 31

PMID 29846876

Citations 6

Authors

Tomohito Saito

Yukihito Saito

Kento J Fukumoto

Hiroshi Matsui

Takahito Nakano

Yohei Taniguchi

Hiroyuki Kaneda

Toshifumi Konobu

Koji Tsuta

Tomohiro Murakawa

Affiliations

Soon will be listed here.

Abstract

Objectives: Accumulating evidence suggests that spontaneous pneumothorax (SP) in women, while relatively rare, has higher rates of post-treatment recurrence than in men. Our aim was to further elucidate the clinical and pathological characteristics of SP in women.

Methods: We retrospectively reviewed 59 female patients with no known underlying lung disease undergoing surgery for their SP from January 1990 to December 2015. We divided the study population into those older than or equal to 50 years and those younger than 50 years, the latter of which was further subdivided into catamenial and non-catamenial pneumothorax.

Results: Among the study population, 11 (18.6%) had catamenial pneumothorax, 40 (67.8%) had non-catamenial pneumothorax, and 8 (13.6%) were older than 50 years. Pathological diagnoses of catamenial pneumothorax were diaphragmatic endometriosis (n = 4), emphysematous bullae (n = 4), solitary pulmonary capillary hemangiomatosis (SPCH, n = 2), and hematoma (n = 1). By contrast, emphysematous blebs/bullae accounted for all but one case of non-catamenial pneumothorax and all cases in the ≥ 50 years age group. Catamenial pneumothorax showed a significantly higher postoperative recurrence rate compared to non-catamenial pneumothorax (p = 0.0043). The 2-year cumulative ipsilateral recurrence rates of catamenial, non-catamenial, and ≥ 50 years age group were 39.4, 13.8, and 14.3%, respectively.

Conclusions: Catamenial pneumothorax affected approximately 20% of female patients undergoing surgery for spontaneous pneumothorax with no underlying lung disease and showed a significantly higher postoperative recurrence rate. Diaphragmatic endometriosis and subpleural blebs/bullae were common pathological findings in catamenial pneumothorax, but SPCH might be a possible pathological diagnosis of catamenial pneumothorax.

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Pulmonary capillary haemangiomatosis: a distinct entity?.

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