Highlights
- •Both hypothyroidism and thyrotoxicosis may induce a pleural effusion.
- •Thoracic endometriosis can cause catamenial pneumothorax or hemothorax.
- •Surgery and hormone therapy are recommended in recurrent catamenial pneumothorax.
- •Pleural effusion due to hormone-sensitive cancer may improve with endocrine treatment.
- •Solitary fibrous tumor of pleura can affect different endocrine functions.
Abstract
The functioning of the pleura and the endocrine system are not entirely independent
of each other. Some hormones can reach a greater concentration in the pleural exudate
than in the blood. However, the clinical significance of this finding remains unknown.
In some circumstances, hormonal changes are responsible for pathological manifestations
in the pleura. Hypothyroidism is one of the most common diseases that can cause a
pleural effusion, likely resulting from alterations in capillary permeability. The
presence of ectopic endometrial tissue within the lung parenchyma, pleura, pericardium
or diaphragm is known as thoracic endometriosis and is one of the causes of catamenial
pneumothorax and /or catamenial hemothorax, which can affect women of childbearing
age and arises within 72 h from the onset of menstruation. Treatment and prevention
of recurrent catamenial pneumothorax / hemothorax usually requires an approach that
combines surgery and hormone therapy. Malignant pleural effusion from breast cancer
may contain estrogen receptor-positive cells. In such a case, endocrine treatment
may be effective in reducing the amount of pleural fluid and the associated symptoms.
Thyroid cancer and lymphangioleiomyomatosis (LAM) are further hormone-sensitive malignancies
in which pleura is frequently involved. The solitary fibrous tumor of pleura (SFPT)
is an example of a pleural disease that can cause hormonal balance disorders. It can
lead to a rise in the releasing factor for growth hormone (GHRH), human beta chorionic
gonadotropin (Beta-hCG), and insulin-like growth factor 2 (IGF2). The consequence
of such hormonal imbalance include hypertrophic pulmonary osteoarthropathy, gynecomastia,
and refractory hypoglycemia, respectively.
Keywords
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Article info
Publication history
Published online: January 13, 2020
Accepted:
December 30,
2019
Received in revised form:
December 21,
2019
Received:
September 11,
2019
Identification
Copyright
© 2020 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
