right middle lobe syndrome

Right middle lobe syndrome refers to chronic right middle lobe collapse, without an obstructing lesion. It is usually with associated bronchiectasis.

Epidemiology

Right middle lobe syndrome is usually encountered in older adults, with a predilection for women (see Lady Windermere syndrome). It is also seen in children .

Clinical presentation

In most cases, patients are asymptomatic. Otherwise, a chronic cough is the most common symptom. Hemoptysis, chest pain, and dyspnea are also reported .

Pathology

The underlying etiology of right middle lobe syndrome remains poorly understood, but poor collateral ventilation, a relatively narrow ostium, and infection/inflammation are all thought to play a role . The histological process identified in such cases include :

Radiographic features

The radiographic features of right middle lobe syndrome are a combination of:

Importantly, an obstructing bronchial lesion is usually not found.

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