Sk. Ohri et al., ACQUIRED SEGMENTAL EMPHYSEMA - THE ENLARGING SPECTRUM OF SWYERJAMES MACLEODS-SYNDROME, The Annals of thoracic surgery, 56(1), 1993, pp. 120-124
Three cases of Macleod's syndrome are described, all of which required
surgical resections for distressing symptoms. This provided a rare op
portunity to examine the pathologic features of a condition that is us
ually diagnosed on its radiologic features, and the etiology of which
remains unestablished. Three patients (2 women and 1 man), aged 20, 23
, and 24 years, were referred from respiratory physicians because of u
nilateral hyperlucent lungs and associated symptoms. All 3 patients ha
d unilateral hyperlucent lungs, but only 1 patient had demonstrable me
diastinal shift on expiratory and inspiratory chest computed tomograph
ic scan. Segmentectomies were performed (n = 4) in all the patients wi
thout perioperative morbidity or mortality. Patients have been followe
d up between 6 and 18 months, and remain asymptomatic with a return to
normal lifestyle. Histologic examination of the specimens found infla
mmation of the bronchus in all 3 patients, but only two specimens had
evidence of bronchiolar inflammation. In only 1 patient was there a re
duction in bronchiole number. All 3 patients showed presence of emphys
ema. These cases are notable for the segmental distribution of the dis
ease. Pathologic examination lends support to the theory that previous
respiratory tract infection may play a role in the pathogenesis of th
is condition.