Delayed Diagnosis in a Patient with Bronchiectasis: Swyer-James-MacLeod Syndrome

Swyer-James/MacLeod syndrome (SJMS) is a rare disease, characterized by unilateral hyperlucent lung due to hypoplasia of the pulmonary artery and bronchiectasis. Illnesses such as viral bronchiolitis and pneumonia in childhood are thought to be an acquired form. A 48-year-old woman applied to the hospital with symptoms including shortness of breath, sputum, and cough. Her medical history revealed that these symptoms had been relapsing since her childhood. She had been diagnosed and monitored for chronic bronchitis and bronchiectasis for the past 10 years. A physical examination revealed that the respiratory sounds of the lower left lobe decreased more than the right side, and revealed coarse crackles in the both middle, anterior, and inferior hemithorax. Chest radiography showed a loss of volume of the left lung, hiperlucency, and areas of bronchiectasis in the lower left lobe. Computed tomography showed that calibration of left pulmonary artery and its branches significantly decreased compared to the right side. We present our case simply because the majority of SJMS cases are diagnosed in childhood and young adulthood; however, our patient was examined several times with the same symptoms and not diagnosed until the age of 48. This syndrome should be considered in the differential diagnosis of patients who have hyperlucent lung.