Case of the Week - Patient Summary 6664Peer Reviewed and Certified -
O Obstruction (i.e. airway foreign body)
E Embolus/Emphysema
M Mastectomy (not applicable in this young male)
S Swyer-James Syndrome
Swyer-James Syndrome Etiology: likely secondary to childhood adenoviral infection with subsequent acute obliterative bronchiolitis, bronchiectasis, and distal air-space destruction
Clinical Presentation: varies from asymptomatic to DOE, usually relates a history of recurrent childhood respiratory infections
Radiographic Findings
- increased lucency in affected lung (usually entire lung with lobar/subsegmental distribution having been reported)
- small ipsilateral hemithorax with normal-to-decreased volume
- small ipsilateral hilum
- air trapping on expiratory films
- V/Q scan classically shows decreased perfusion as well as diminished ventilation with delayed washout
- angio will show a “pruned tree” appearance of affected side’s pulmonary vasculature
