1/5. 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.- - - - - - - - - - ranking = 1keywords = emphysema (Clic here for more details about this article) |
2/5. Surgically treated Swyer-James syndrome.Because patients with Swyer-James syndrome have almost always been treated conservatively, few reports exist of pathological findings of the lung in this syndrome. We report a case of this rare disease treated surgically and discuss pathological findings. A 36-year-old woman repeatedly contracted bronchitis and pneumothorax since adolescence, until April 26, 1997, when she reported chest pain and dyspnea. Chest X-ray on admission showed left pulmonary collapse with a slight deviation of the mediastinum toward the right. Chest computed tomography showed an apical bulla and emphysematous change in the left upper lobe. Pulmonary arteriography at age 17 showed hypoplasia of left pulmonary artery branches in the left upper lobe. Based on a diagnosis of Swyer-James syndrome, we conducted left upper lobectomy on May 2, 1997. Pathological examination of the resected left upper lobe showed marked emphysematous change, including an emphysematous bulla with destruction of alveolar structure and peribronchiolar fibrosis. No vascular abnormality was recognized in histology. Emphysematous change secondary to repeated bronchiolitis is believed to have led to her repeated pneumothorax.- - - - - - - - - - ranking = 3keywords = emphysema (Clic here for more details about this article) |
3/5. Basilar hyperlucency in a patient with emphysema due to hypocomplementemic urticarial vasculitis syndrome.Disproportionate emphysematous involvement of the lung bases, compared with the apices, sometimes called basilar hyperlucency, is an unusual radiographic pattern that has been reported primarily in patients with alpha-1 antitrypsin deficiency, but also in individuals with emphysema caused by intravenous injection of methylphenidate. We present a patient with emphysema associated with hypocomplementemic urticarial vasculitis syndrome and whose chest radiograph demonstrated basilar hyperlucency. To the extent that basilar hyperlucency has not been well recognized as a feature of hypocomplementemic urticarial vasculitis syndrome, this report extends the spectrum of causes of this unusual radiographic pattern of emphysema.- - - - - - - - - - ranking = 8keywords = emphysema (Clic here for more details about this article) |
4/5. Swyer-James (MacLeod) syndrome with placental transmogrification of the lung: a case report and review of the literature.Swyer-James (MacLeod) syndrome is an acquired form of unilateral hyperlucency of the lung and is characterized by the development of severe emphysema, bronchiectasis, and/or bronchiolitis obliterans. It may develop as a complication of repeated episodes of pulmonary infection resulting in bronchiolitis obliterans and obstruction of small airways. Most patients with Swyer-James (MacLeod) syndrome can be managed clinically, and the pathologic features of the syndrome have been described in only a few reports. Placental transmogrification of the lung is a rare histopathologic finding that has been described in patients with severe emphysema associated with cigarette smoking, congenital bullous emphysema, and fibrochondromatous hamartomas of the lung and is characterized by the development of peculiar structures in the pulmonary parenchyma that resemble placental villi. To our knowledge, placental transmogrification of the lung has not been previously described in patients with Swyer-James (MacLeod) syndrome. We encountered a 32-year-old man with a history of childhood asthma who presented with progressively severe exertional dyspnea and had unilateral right lung hyperlucency. The patient underwent a right pneumonectomy. Examination of the lung revealed severe mixed centriacinar-panacinar emphysema in all lobes, bullous emphysema in the upper lobe, bronchiectases, mild interstitial pneumonia with fibrosis, and placental transmogrification of the pulmonary parenchyma of all 3 lobes. Here, we review the pathology of Swyer-James (MacLeod) syndrome and the possible pathogenesis of villous-like changes in the lung tissues.- - - - - - - - - - ranking = 5keywords = emphysema (Clic here for more details about this article) |
5/5. lung volume reduction surgery for a professional athlete with Swyer-James syndrome.Swyer-James syndrome is an uncommon, emphysematous disease characterized by roentgenographic hyperlucency of one lung or lobe due to loss of the pulmonary vascular structure and to alveolar overdistension. We here describe a 28-year-old professional bicycle racer with Swyer-James syndrome who had dyspnea on exertion, especially during a bicycle race. lung volume reduction surgery was performed with video-assisted thoracoscopic surgery. This treatment improved his pulmonary function, and he is active as a bicycle racer now.- - - - - - - - - - ranking = 1keywords = emphysema (Clic here for more details about this article) |