Middle lobe syndrome in left lower lobe.

Middle lobe syndrome in left lower lobe.

• Ugur Gonlugur University, School of Medicine
• Tanseli Gonlugur Canakkale City Hospital

Keywords: Middle lobe syndrome, pulmonary atelectasis, bronchiectasis

Abstract

Middle Lobe Syndrome is a term that refers to a persistent or recurrent collapse of a lung lobe, especially the right middle lobe. A 66-year-old woman presented with chronic cough with sputum and recurrent attacks of pneumonia. She was treated with antibiotics. Chest CT-scan showed a left lobe atelectasis and multiple foci of bronchiectasis. Bronchoscopy revealed a patent left lower lobe bronchus. In conclusions, middle lobe syndrome can rarely affect left lower lobe. It should be kept in mind in the differential diagnosis of recurrent pneumonia.

References

De Boeck K, Willems T, Van Gysel D, Corbeel L, Eeckels R. Outcome after right middle lobe syndrome. Chest 1995; 108
(1): 150-152.

Graham EA, Burford TH, Mayer JH. Middle lobe syndrome. Postgrad Med 1948; 4 (1): 29-34.

Brock RC, Cann RJ, Dickinson JR. Tuberculous mediastinal lymphadenitis in childhood; Secondary effects on the lungs. Guy’s
Hosp Rep 1937; 87: 295.

Sekerel BE, Nakipoglu F. Middle lobe syndrome in children with asthma: review of 56 cases. J Asthma 2004; 41: 411-417.

Hamad AM, Elmistekawy E, Elatafy E. Chronic atelectasis of the left lower lobe: a clinicopathological condition equivalent to middle lobe syndrome. Interact Cardiovasc Thorac Surg 2012; 15(4): 518-621.

Blaivas AJ, Strauss W. Middle lobe syndrome in the left lower lobe in chronic obstructive pulmonary disease. Prim Care
Respir J 2009; 18(4): 331-333.

Wagner RB, Johnston MR. Middle lobe syndrome. Ann Thorac Surg 1983; 35 (6): 679-685.

Kala J, Sahay S, Shah A. Bronchial anthra cofibrosis and tuberculosis presenting as a middle lobe syndrome. Prim Care Respir J
2008; 17(1): 51-55.

Kunal S, Pilaniya V, Shah A. Middle lobe syndrome: a singularly rare presentation of complicated pulmonary hydatid disease. BMJ Case Rep 2016 Apr 4; 2016 pii: bcr2016214670. doi: 10.1136/bcr-2016-21
4670.

Woźniak MS, Buchwald J, Stockdale I, Doniec Z. Tracheobronchopathia osteochondroplastica - a 61-year-old female with
middle lobe syndrome. Adv Respir Med 2017; 85(3): 158-160.

Chien HP, Lin TP, Chen HL, Huang TW. Right middle lobe atelectasis associated
with endobronchial silicotic lesions. Arch Pathol Lab Med 2000; 124(11): 1619-1622.

Panitch HB. Evaluation of recurrent pneumonia. Pediatr Infect Dis J 2005; 24(3): 265-266.

Dhillon SS, Watanakunakorn C. Lady Win dermere syndrome: middle lobe bronchiectasis and Mycobacterium avium complex infection due to voluntary cough suppression. Clin Infect Dis 2000; 30(3): 572-575. 52 Gonlugur and Gonlugur

Terry PB, Traystman RJ. The clinical significance of collateral ventilation. Ann Am Thorac Soc 2016; 13(12): 2251-2257.

Takahashi H, Kimura S, Nagai I, Kubota M, Aono K. A case of middle lobe syndrome occurring in two sisters. Jpn J Surg 1990;
20(5): 597-601.

Kawamura M, Arai Y, Tani M. Improvement in right lung atelectasis (middle lobe syndrome) following administration of lowdose roxithromycin. Respiration 2001; 68 (2): 210-214.

Miyazaki A, Ashizawa K, Mori M, Ohtsubo M. Right middle lobe atelectasis: chest radiographic and CT appearances correlating
with the clinical features. Acta Med Nagasaki 2003; 48: 159-166.

Gudbjartsson T, Gudmundsson G. Middle lobe syndrome: a review of clinicopathological features, diagnosis and treatment. Respiration 2012; 84(1): 80-86.