Macleod syndrome
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Transcript of Macleod syndrome
Macleod syndromeMacleod syndrome
Swyer James syndromeSwyer James syndrome
Dr/ Hytham Nafady
Definition Definition
Idiopathic hyperlucent lungIdiopathic hyperlucent lung
Etiology Etiology
Acute viral Acute viral bronchiolitis bronchiolitis during infancy during infancy that prevent that prevent normal normal development of development of the lungthe lung..
Central bronchiectasis
Acute obliterative bronchilolitis
Distal air space destruction
Pathology
C.PC.P
Asymptomatic in most cases.Asymptomatic in most cases. Cough, dyspnea on exertion.Cough, dyspnea on exertion. History of recurrent lower respiratory tract History of recurrent lower respiratory tract
infection during childhood.infection during childhood.
Location Location
Unilateral.Unilateral. Usually entire lung but may be lobar or segmental.Usually entire lung but may be lobar or segmental.
Plain radiographyPlain radiography and CT and CT
Unilateral Unilateral hyperlucencyhyperlucency.. SmallSmall pulmonary vessels pulmonary vessels (diminished number (diminished number
& size).& size). Small Small hilumhilum.. Small Small hemithoraxhemithorax.. Ipsilateral Ipsilateral mediastinal shift mediastinal shift (sometimes (sometimes
contralateral shift if associated with air contralateral shift if associated with air trapping).trapping).
Small pulmonary vessels Small hilum.Small hemi-thorax.
Ipsilateral mediastinal shift Unilateral hyper-lucency
CT bronchographyCT bronchography
Central bronchiectasisPeripheral bronchial cut off
pruned tree pruned tree bronchgrambronchgram
CT pulmonary angiographyCT pulmonary angiography
Diminished pulmonary vasculature.Diminished pulmonary vasculature.
Ventillation / perfusion lung scanVentillation / perfusion lung scan
Ventilation scan:Ventilation scan: Diminished ventillation.Diminished ventillation. Air trapping during expiration.Air trapping during expiration.
Perfusion scan:Perfusion scan: Diminished perfusion. Diminished perfusion.
DD of unilateral hypertranslucencyDD of unilateral hypertranslucency
Chest rotationChest rotation
Mastectomy Mastectomy
Poland syndromePoland syndrome
LobectomyLobectomyRight upper lobectomyRight upper lobectomy Left upper lobectomy.Left upper lobectomy.
Hyperlucent right lung.Hyperlucent right lung.The right hilum is elevated and The right hilum is elevated and become at the same level as the become at the same level as the left hilum.left hilum.
Hyperlucent left lung.Hyperlucent left lung.The left hilum is elevated.The left hilum is elevated.
Quiz Quiz
History: 10Y Boy with cough.
A Pneumothorax.
B Lobar emphysema
C Pulmonary artery hypoplasia.
D Unilateral pulmonary edema.
E None of the above What to do next? CT
Findings: CXR shows that the left hemithorax is lucent when compared with the right. The lungs are equally inflated. Vascularity is symmetric. The vessels are sharp. CT shows absence of left pectoralis major and pectoralis minor muscles.
Diagnosis: Poland Syndrome
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