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PubMed2001

Utility of ventilation and perfusion scan in the diagnosis of young military recruits with an incidental finding of hyperlucent lung.

Swyer-James-MacLeod syndrome (SJMS) is considered to be a relatively uncommon disease presenting with unilateral hyperlucent lung due to hypoplasia of a pulmonary artery and bronchiectasis of the affected lung. In this report, we describe the ventilation-perfusion (V/Q) scan findings of nine male recruits (aged 20-29 years, mean 24.4+/-2.96 years) with SJMS in whom the diagnosis was first established in adulthood. V/Q scan findings of all patients were compared with those on planar radiographs, pulmonary function studies, high resolution computed tomography (HRCT) and digital subtraction angiography (DSA). The ventilation (133Xe) and perfusion (99Tcm-macro-aggregated albumin) scans showed the characteristic pattern of a matched V/Q defect and marked air trapping on the washout phase on 133Xe scintigraphy. HRCT displayed hypodense lung with integrity of main airways, and markedly diminished vasculature on the affected side in all patients. A smaller pulmonary artery on the affected side with poor peripheral vasculature was observed with DSA in all patients. All patients had features of obstructive airway disease in varying degrees on pulmonary function studies. In contrast to other imaging methods, bronchiectasis as an etiological factor was displayed on HRCT. Some pulmonary areas, which were normal on HRCT and planar radiographs, showed air trapping on V/Q scan. Although a V/Q scan was more helpful in determining the extent of the disease and correlates well with conventional imaging methods, HRCT was the most valuable imaging method for the evaluation of aetiology in unilateral hyperlucent lung.

Adult↗
PubMed1990

Ventilation-perfusion scintigraphy in an adult with congenital unilateral hyperlucent lung.

A variety of congenital and acquired etiologies can give rise to the radiographic finding of a unilateral hyperlucent lung. An unusual case of congenital lobar emphysema diagnosed in a young adult following the initial discovery of a hyperexpanded, hyperlucent lung is reported. Although subsequent bronchoscopy and radiologic studies detailed extensive anatomic abnormalities, functional imaging also played an important role in arriving at this rare diagnosis. In particular, ventilation-perfusion scintigraphy identified the small contralateral lung as the functional lung and helped narrow the differential diagnosis to etiologies involving obstructive airway disorders.

Adult↗
PubMed1999

Mediastinal esophageal cyst causing unilateral hyperlucent lung.

Unilateral emphysema secondary to bronchial obstruction by a foregut-derived mediastinal cyst is rare. Here we describe an infant with a unilateral hyperlucent lung due to compression on the left main bronchus by an esophageal cyst, visualized by chest computed tomography and magnetic resonance imaging. A chest roentgenogram and a perfusion scan presented the normalized left lung after resection of the cyst.

Esophageal Cyst↗
PubMed1994

Scintigraphy, angiography and computed tomography in unilateral hyperlucent lung due to obliterative bronchiolitis.

This study examines the value of different imaging methods in assessing the anatomic structures of unilateral hyperlucent lung due to obliterative bronchiolitis. We studied 9 patients, 5 males and 4 females, suffering from UHL (mean age 49 years). Ventilation-perfusion scan (VPS) and computed tomography (CT) of the chest were performed in all, and conventional angiography or digital substraction angiography (DSA) in 7 patients. The VPS showed the characteristic pattern of a matched ventilation-perfusion defect and considerable air trapping during the washout phase. Conventional angiography and DSA displayed a smaller pulmonary artery on the affected side, with a poor peripheral vasculature. CT displayed a loss of lung volume in all cases, with diminished mean attenuation values, a markedly diminished vasculature and integrity of the main airways. In contrast to other imaging modalities, CT imaged bronchiectasis, which was the cause of the patients' clinical symptoms of bronchorrhea and hemoptysis. We conclude that CT of the chest is the most valuable imaging method for evaluating unilateral hyperlucent lung, particularly in symptomatic patients.

Adult↗
PubMed1988

Presentation of Pneumocystis carinii pneumonia as unilateral hyperlucent lung.

Pneumocystis carinii pneumonia (PCP) presented as unilateral hyperlucent lung in a 27-month-old patient with a brain tumor who was receiving chemotherapy. Although unilateral pneumonia is an uncommon presentation of PCP in non-AIDS patients, PCP must be suspected in any pediatric cancer patient not receiving trimethoprim-sulfamethoxazole prophylaxis and receiving intensive chemotherapy.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1980

Unilateral hyperlucent lung: the case for investigation.

Seventeen children with unilateral hyperlucent lungs were referred for investigation. Of the 11 who had a referring diagnosis of possible Macleod's syndrome only two were shown to have post-viral bronchiolitis. Three of the 11 had conditions that required surgical treatment and a further two with brochiectasis were treated medically. To avoid confusion we suggest that Macleod's syndrome is reserved exclusively for children with post-viral bronchiolitis. Radioisotopic regional lung function studies were useful in the investigation of the subjects from three points of view. Firstly, they distinguished children with primary perfusion abnormalities and normal ventilation, secondly, they defined the extent of altered respiratory function, and thirdly, they were able to distinguish compensatory emphysema from congenital lobar emphysema. As bronchography and bronchoscopy may be hazardous in small children with poor respiratory reserve, such regional studies may be useful in indicating which patients do not require further invasive investigation.

Child↗
PubMed1982

[The differential diagnosis of the unilateral by hyperlucent lung. Two case reports (author's transl)].

The "unilateral hyperlucent lung" is a roentgenologic diagnosis based on an increased radiolucency of one lung. Aetiology and pathogenesis of this clinical syndrome are discussed together with two own case reports about a 9-year-old girl and a 3-month old boy. Anamnesis, bronchography, scintigraphy and angiocardiography in the girl revealed a Swyer-James syndrome, where typically only one lung is damaged by obliterating bronchiolitis. In the patient the pulmonary changes developed subsequently to a measles-pneumonia, possibly enhanced by an additional pollinosis. The 3-month old infant had a left-sided pulmonary artery hypoplasia and obstructive bronchitis in both lungs. Up to its 7th month of life the child developed sufficiently under conservative therapy, but then a life threatening pneumonia with obstructive bronchitis and respiratory failure occurred, 3 weeks of artificial respiration were without success. The subsequent pneumectomy revealed a hypoplasia of the left lung and a big tracheal cyst as cause of the severe obstruction.

Age Factors↗
PubMed1984

Swyer-James syndrome--unilateral hyperlucent lung syndrome. A case report and review.

Swyer-James syndrome is a pulmonary condition acquired following bronchiolitis obliterans early in life. Clinically characterized by repeated bouts of pulmonary infections, Swyer-James syndrome is characterized radiographically by a unilateral small, hyperlucent lung that demonstrates diminished arterial supply to the involved lung, air-trapping, and bronchiectasis. Radioimaging procedures may reveal otherwise unsuspected bilateral involvement. A 14-year-old Caucasian female with classic findings of Swyer-James syndrome is presented. The differential diagnosis of conditions that may present with a unilateral hyperlucent lung is discussed. Therapy is aimed primarily at control of the intercurrent episodes of bacterial pneumonia.

Adolescent↗
PubMed1982

[Differential diagnosis of a unilateral hyperlucent lung: the Swyer-James syndrome].

Lower respiratory infections in infancy caused lung emphysema in a 10-year old girl; being a locus minoris resistentiae the emphysema led to recurrent pulmonary complaints. This corresponds to the definition of the Swyer-James or McLeod Syndrome. The radiologic clue to the diagnosis is often the "unilateral hyperlucent lung", which is also found in many other childhood diseases. With our case we present an economical way of differentially diagnosing the unilateral hyperlucent lung, a way that is as little invasive as possible.

Bronchography↗
PubMed1977

[Syndrome of the unilateral or partially "hyperlucent lung"].

The paper presents the picture of the unilateral or partial "hyperlucent lung" syndrome. The most common causes of this anomaly are described according to pathological and anatomical criteria. The difficult diagnosis of its X-ray-appearance is discussed. The value of differential diagnostic criteria is demonstrated in suitable cases. Differentiation from the pseudo-syndrome is also outlined. Various methods of radiological examination are described and evaluated.

Angiocardiography↗
PubMed1975

Hyperlucent lung after radiation therapy.

A 63-year-old woman was demonstrated to have a hyperlucent lung in a hemithorax irradiated 9 years previously for carcinoma of the breast. This is the second reported concurrence of these events.

Angiography↗
PubMed1979

[Dystrophic hyperlucent lung (author's transl)].

Emphysematous bullae isolated on a healthy lung and primitive progressive dystrophic emphysema all belong to the dystrophic hyperlucent lung and are surgical cases. Having recalled the excellent prognosis of isolated bullae, the authors analyzed the surgical indications in the progressive dystrophic emphysema concerning 66 observations of which 52 cases were operated. They showed that surgery provided many improvements and that making a pleural adhesion during the intervention limited the bullous evolution of the disease. Results plead in favour of early interventions and wider indications.

Adult↗