Discussion Author: Kevin Banks
Swyer-James Syndrome is also called "unilateral hyperlucent lung". This a radiologic *classic* where one lung field is more radiolucent (darker) on chest films.
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
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