Figure 1 - uploaded by Tulin Sevim
Content may be subject to copyright.
a-c. Case 1, PA chest x-ray: small right hilum, increased aeration in the inferior lobe of the right lung (arrow); MR angiography: hypoplasia in the descending branch of the right pulmonary artery (arrow); HRCT: bilateral cystic bronchiectasis
Source publication
Swyer-James-MacLeod syndrome or unilateral hyperlucent lung syndrome is a rare disease characterised by hypoplasia of the pulmonary artery, unilateral hyperlucent lung and usually bronchiectasis. The syndrome was first described by Swyer and James in 1953 in a child case, and in the following year 9 adult cases were reported by MacLeod. We retrospe...
Similar publications
We report a case of young adult with unilateral lung
hyperlucency. His radiological features were suggestive of
Swyer–James syndrome. The condition is uncommon in
adults. We report this rare case with discussion on clinical
presentation, diagnosis, and management of Swyer–James
syndrome. The report also throws light on various other
causes of unila...
Citations
... Swyer-James-MacLeod syndrome was first reported in 1953 by Swyer and James in a 6-year-old boy [5] and in 1954, Macleod described the syndrome in nine adults with unilateral lung hyperlucency [6]. The prevalence of this syndrome has been reported to be 0.01% [7]. Swyer-James-MacLeod syndrome is typically diagnosed in childhood. ...
Swyer-James-Macleod syndrome is an infrequent clinical condition characterized by unilateral hyperlucent lung as a complication following infectious bronchiolitis obliterans, typically diagnosed during childhood. However, in some patients, the diagnosis may be confirmed in adulthood. The syndrome can be misdiagnosed with other lung disorders such as asthma, pulmonary embolism, and pneumothorax, leading to inappropriate management and worse outcome. We present a case of Swyer-James-MacLeod syndrome, diagnosed in a 63-year-old man, with frequent hospitalisations due to chronic obstructive pulmonary disease (COPD) exacerbations without a history of significant lung infection in childhood. Complications of Swyer-James-MacLeod syndrome include recurrent infections, lung abscess, pneumothorax, and pulmonary hypertension. The syndrome should always be considered in adults with recurrent respiratory infections or pulmonary hyperlucency on chest imaging to prevent a delay in correct diagnosis and improper treatment.
... 5 Esto hace que, muchas veces, sobre todo, si la sintomatología no es muy florida, pase desapercibido y se diagnostique en la edad adulta. 6 En este artículo, se presenta el caso de un niño de 6 años con diagnóstico de SSJML. ...
Swyer-James-MacLeod syndrome is a rare pulmonary disorder that is characterized radiologically by pulmonary lobar or multilobar hyperlucency produced by decreased pulmonary vascularization usually due to a previous infectious process. It is frequently a casual finding in recurrent pulmonary infections or in the study of asthma symptoms. We present the case of a 6-year-old patient who was diagnosed with Swyer-James-MacLeod syndrome after a persistent pneumoniae. A multidisciplinary approach was conducted, with a satisfactory progress up to date, combining medical treatment with respiratory physiotherapy.
Sociedad Argentina de Pediatría.
Swyer – James syndrome, also called Swyer – James – MacLeod syndrome (SJMS), is a rare acquired disorder characterized by pulmonary artery hypoplasia, unilateral hyperlucent lungs, and usually also bronchiectasis. Adults with SJMS are often diagnosed with and treated for chronic obstructive pulmonary disease (COPD), bronchial asthma, pneumothorax, or pulmonary embolism due to the similar clinical manifestations. Underestimation of an important radiological sign – unilateral “impoverishment” of the pulmonary pattern and hyperlucent lung – leads to erroneous diagnosis and inadequate treatment. Diagnosis of SJMS involves a computed tomography scan of the chest. The aim of this work was to familiarize readers with aspects of diagnosis and detail the clinical, radiological, and other characteristics of a patient with McLeod syndrome. The described adult man was diagnosed with SJMS at the age of 32. Some typical mistakes in examinations of such patients and the lack of vigilance of radiologists in case of unilateral hyperlucent lung are presented. Conclusion . Using the example of a rare clinical case of SJMS, we demonstrated the need to consider this syndrome when diagnosing adults with unjustified shortness of breath and a history of frequently recurrent pulmonary infections, with radiological signs of unilateral pulmonary emphysema and hyperlucent lung. According to the literature and our observations, computed tomography of the chest organs is a fast and reliable method for establishing the diagnosis of SJMS.
Hyperlucent lung syndrome or Swyer-James-Macleod syndrome is a rare, often incidental finding, primarily showing unilateral hyperlucency as a consequence of bronchiolitis obliterans. Often diagnosed in early childhood, though in some cases, it may only be discovered in adulthood or on account of recurrent chest infections. An 88-year-old patient presented to our outpatient center with complaints of shortness of breath with mild to moderate exertional dyspnea and exacerbations of symptoms classically associated with chronic obstructive pulmonary disease. Complaints have persisted for several years with waxing and waning intensity. There is a history of migraine, atrial fibrillation, hypothyroidism, and colon and breast cancer without recurrence. Computed tomography of the chest with intravenous contrast showed asymmetric emphysematous changes with marked hyperinflation and attenuated vasculatures confined to the middle lobe of the right lung. The patient was started on a combination of inhaled long-acting beta-agonists, corticosteroids, and long-acting muscarinic antagonists and is almost asymptomatic. Geriatric patients are at increased risk of various age-related diseases, respiratory disorders being among them. Knowledge of this rare condition allows for its appropriate management as it often coexists with bronchiectasis and results in frequent respiratory infections, which may be preventable.
Introduction
Swyer-James-MacLeod syndrome (SJMS) is a rare obliterative pulmonary disease, usually found in children. The current study aims to report a rare adult case of SJMS.
Case report
A 21-year-old married female presented with dyspnea mainly on exertion. Physical examinations were normal and chest examination showed mild decrease in breathing sounds on the right lower zone. High-resolution computed tomography (HRCT) scan of the chest showed hyperlucency of the right lung with the loss of normal lung vasculature. The patient was managed conservatively with antibiotics, bronchodilator inhaler, and influenza vaccination. The patient was in good health upon follow up.
Discussion
SJMS is considered as a type of post infective obliterative bronchiolitis, which is mainly found in children. Only a few cases have been diagnosed in adults. The syndrome usually occurs following lung infections early in childhood, possibly due to infective agents, such as adenovirus.
Conclusion
Diagnosis of SJMS in adulthood is a very rare finding which may be found despite the absence of any history of pulmonary infections during childhood.
Swyer-James-MacLeod Syndrome (SJMS) is a rare disease characterized by a hyperlucent lung
appearance due to hypoplasia of the pulmonary artery on the affected side. It is thought to
develop secondary to viral bronchiolitis and pneumonia in childhood. A 59-year-old female
patient presented with the complaints of dyspnea with exertion, a feeling of pressure in the
chest, and sputum. On physical examination, respiratory sounds were normal. Posteroanterior
(PA) chest X-ray showed marked hyperlucency and volume loss in the left hemithorax. On thorax
computed tomography, ipsilateral hyperlucency with a significant decrease in the calibration of
the left pulmonary artery and its branches compared to the right, significant volume loss in the
lower lobe of the left lung and areas of bronchiectasis were observed. While large segmental
perfusion defects were observed in almost the entire lower lobe of the left lung and in the
lingular segment in perfusion scintigraphy, ventilation defects were observed in these areas in
ventilation scintigraphy. The patient was diagnosed with SJMS based on the present findings.
Treatment of the disease is conservative in most cases. It is recommended to protect patients
against infections and to have flu and pneumococcal vaccines. We present our case to emphasize
that this syndrome should be among the differential diagnoses when unilateral hyperlucent lung
appearance is detected.
