CTICasesCentral Bronchial Carcinoid mimicking Swyer-James-MacLeod Syndrome
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Imaging findings
Chest radiograph and CT demonstrate a hyperlucent, overinflated right lung with attenuated vascularity, mimicking Swyer-James-MacLeod syndrome. On CT, a soft tissue mass is identified causing high-grade obstruction of the right main bronchus. Retained secretions and air-fluid levels are visible in the right middle and lower lobe bronchi distal to the obstruction, along with mediastinal lymphadenopathy. Bronchoscopy confirmed a central bronchial carcinoid.
Key takeaways
A unilateral hyperlucent lung on radiography can be caused by obstructive overinflation (air trapping) due to a central airway mass. While Swyer-James-MacLeod syndrome is a post-infectious bronchiolitis obliterans that presents with a small, hyperlucent lung, a central tumor like a bronchial carcinoid should always be excluded when a patient presents with unilateral hyperlucency, progressive dyspnea, or wheezing.
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