F. Long*a (Prof), L. Longa (Ms), T. Wanga (Mr), P. Fua (Mr), W. Huanga (Ms)

a University of Chinese Academy of Sciences Shenzhen Hospital, Shenzhen, CHINA

* longfa_923@163.com

A 34-year-old female patient was admitted to our hospital on December 23rd, 2020 due to "recurrent hemoptysis for more than one year". The patient began to develop menstrual hemoptysis without obvious incentive from October 2019. she visited another hospital, Chest CT revealed solid small nodules in the lateral middle lobe of the right lung, which were considered as benign lesions. Bronchoscopy suggested: active hemorrhage in the posterior segment of the upper left apex; Ultrasonography revealed: 1. abnormal intrauterine echo, and the possibility of endometrial polyp remained to be excluded; 2. hypertrophy of uterus, abnormal echo of muscle layer, and the possibility of adenomyosis remained to be excluded. The diagnosis of adenomyosis was made, but the specific treatment remained unknown. The patient had her period last night and had hemoptysis again. The last menstruation period (LMP) was 2020-12-22.

Bronchoscopic photodynamic therapy was performed on December 24th, 2020-24

The patient underwent endoscopy through oral endotracheal intubation. BAL was made on the natural branch of the left upper lobe, and more purulent secretions were lavaged. Photodynamic therapy was performed on the apical, anterior and posterior segments of the left upper lobe. (Equipment model: PDT630-A The wavelength:630 nm power: 2W)After the operation, anti-infection treatment like moxifloxacin was given, and the patient was in good condition without hemoptysis, cough, expectoration, chest tightness or dyspnea. In the first month after surgery, she experienced a small amount of hemoptysis during menstruation, and no hemoptysis was seen after the second month.

Preoperative CT: thoracic symmetry; patchy, slightly high-density, and ill-defined shadows were observed in the upper lobe of the left lung.

At 11 months after the operation, the exudative lesions in the upper lobe of the left lung were absorbed and disappeared.

Disclosure of funding source(s): none