Obstetric and gynecologic pathologic conditions can involve the chest and produce a broad clinical and imaging spectrum, ranging from subtle abnormalities to critical cardiopulmonary disease. This review summarizes the unique, often unrecognized or unexpected thoracic imaging manifestations related to both obstetric events (pregnancy, peripartum, postpartum) and gynecologic disease, including benign disorders and malignancies. The goal is to facilitate accurate and timely radiologic diagnosis by linking clinical context, patterns of spread, histopathologic tumor features, and imaging findings.
Pregnant, peripartum, and postpartum patients may present with a variety of thoracic disorders. The review identifies conditions encountered in these populations, including preeclampsia/eclampsia, pulmonary edema, pneumonia, aspiration, acute respiratory distress syndrome (ARDS), thromboembolism and other embolic disease, cardiomyopathy, and metastatic gestational trophoblastic disease.
These entities may have overlapping clinical presentations but different imaging appearances and implications for management. Awareness of the specific obstetric-related causes of chest disease helps prioritize differential diagnoses and select appropriate imaging pathways.
The authors discuss appropriate imaging methods for pregnant patients. Imaging during pregnancy requires balancing diagnostic yield with fetal and maternal safety. Selection of modality, technique, and the need for radiation shielding or alternative modalities are relevant considerations. The review emphasizes that imaging can be essential to diagnose serious cardiothoracic complications in pregnancy and postpartum settings.
Gynecologic malignancies develop characteristic thoracic involvement patterns that are influenced by their pathways of tumor spread and underlying histopathologic features. The review highlights that knowledge of these typical patterns assists radiologists in recognizing metastatic or direct thoracic involvement from gynecologic primary tumors. Laboratory biomarkers are noted as complementary data that can add diagnostic value when interpreting imaging in patients with suspected or known gynecologic malignancy.
Benign gynecologic processes may also manifest in the chest. The review lists notable examples, including Meigs syndrome, thoracic endometriosis syndrome, and intravascular or metastasizing leiomyomatosis. Each of these entities can present with specific thoracic imaging findings and clinical contexts that distinguish them from malignant disease.
The review notes that laboratory biomarkers can provide additional diagnostic information and should be integrated with imaging findings. In the context of gynecologic malignancies and gestational trophoblastic disease, biomarkers may help distinguish etiologies, guide suspicion for metastatic disease, and influence interpretation of thoracic imaging abnormalities.
To facilitate accurate and timely diagnosis, the authors provide an overview tying together clinical presentation, imaging technique selection, and pattern recognition. Key practical points include:
The review underscores that prompt and accurate radiologic assessment can affect clinical management in both benign and malignant settings.
Cardiothoracic involvement by obstetric and gynecologic conditions spans a wide range of diagnoses. The review compiles imaging manifestations of pregnancy-associated thoracic disease, gynecologic malignancy thoracic spread, and benign gynecologic syndromes that present in the chest. It emphasizes appropriate imaging strategies for pregnant patients and the complementary role of laboratory biomarkers. Supplemental material is available with the article for further reference.
Note: This summary is based on the abstract and bibliographic information from the cited review. The source indicates that supplemental material accompanies the full article; details beyond the abstract were not reported in the source provided.