CTICasesSwyer-James-MacLeod Syndrome (Unilateral Hyperlucent Lung)
Imaging findings
Chest radiograph in a young West African woman with clubbing demonstrates a small, hyperlucent right lung with asymmetric vascular markings. CT confirms mosaic attenuation in the right lung with areas of air trapping, scattered bronchiectasis, and bronchovascular scarring, consistent with constrictive obliterative bronchiolitis. The left pulmonary artery is relatively prominent compared to the diminutive right.
Key takeaways
Swyer-James-MacLeod syndrome is a form of post-infectious constrictive obliterative bronchiolitis, typically following viral bronchiolitis in early childhood, producing a unilateral or asymmetrically hyperlucent lung due to air trapping and diminished vascularity. The differential for a hyperlucent lung also includes lobar emphysema, congenital lobar emphysema, and pulmonary hypoplasia. A family history of clubbing or similar lung disease may suggest a hereditary etiology such as surfactant C protein deficiency.
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