Middle Lobe Disease

Rb, McElvein; Mayo, P

doi:10.1097/00007611-196710000-00002

Cited by 8 publications

(15 citation statements)

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“…Out of 18 patients, 13 (72%) were cured of their symptoms and 5 other patients were improved. Similar results have been reported in other studies, including the study by McElvein and Mayo [25], in which 21 of 22 patients (95%) were free of symptoms after surgery. In another study, by Bradham et al [10], all of the 41 surgically treated patients were able to perform normal activities following surgery, and 32 (78%) were free of symptoms.…”

Section: Treatment and Prognosis Of Mlssupporting

confidence: 91%

“…The most common symptoms are chronic or recurrent cough, observed in 30–50% of patients [3,7], dyspnea, chest pain, audible wheezing and fever and chills related to obstructive pneumonia [3,7,20,25]. These symptoms are often intermittent and recurrent.…”

Section: Epidemiology and Clinical Featuresmentioning

confidence: 99%

“…Most often, however, patients have abnormalities on the chest radiograph that are most apparent in the lateral view [5]. The volume loss resulting from collapse of the right middle lobe is seen as a triangle of increased density between the minor fissure and the lower half of the major fissure [5,25] (fig. 1a).…”

Section: Diagnostic Imagingmentioning

confidence: 99%

“…With long-standing collapse, this radiographic density may have a width of only 2–3 mm [5,25]. The posteroanterior radiograph may also show obscuring of the right cardiac border (silhouette sign) [5,25] (fig. 1b) because the medial segment of the middle lobe is contiguous with the right atrium.…”

Section: Diagnostic Imagingmentioning

confidence: 99%

“…1b) because the medial segment of the middle lobe is contiguous with the right atrium. Collapse of the middle lobe is often difficult to detect on the posteroanterior projection because the lobe is relatively thin and lies obliquely in the superoinferior plane [5,25,26]. The presence of air bronchograms suggests at least partial patency of the right middle lobe bronchus [5].…”

Section: Diagnostic Imagingmentioning

confidence: 99%

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Middle Lobe Syndrome: A Review of Clinicopathological Features, Diagnosis and Treatment

Guðbjartsson¹,

Guðmundsson

2012

Respiration

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Middle lobe syndrome (MLS) is a rare but important clinical entity that has been poorly defined in the literature. It is characterized by recurrent or chronic collapse of the middle lobe of the right lung but can also involve the lingula of the left lung. Pathophysiologically, there are two forms of MLS, namely obstructive and nonobstructive. Obstructive MLS is usually caused by endobronchial lesions or extrinsic compression of the middle lobe bronchus such as from hilar lymphadenopathy or tumors of neoplastic origin, resulting in postobstructive atelectasis and pneumonitis. In the nonobstructive type, no obstruction of the middle lobe bronchus is evident during bronchoscopy or with computerized tomography of the chest. The etiology of the nonobstructive form is not completely understood. Inefficient collateral ventilation, infection and inflammation in the middle lobe or lingula are thought to play a role, and bronchiectasis is the most common histological finding. Patients with proven endobronchial lesions or malignancy are usually offered surgical resection directly. This contrasts with nonobstructive MLS, where most patients respond to medical treatment consisting of bronchodilators, mucolytics and broad-spectrum antibiotics. However, some patients do not respond to conservative treatment and may suffer irreversible damage of the middle lobe or lingula, in addition to having recurrent symptoms of infection or inflammation. These selected patients can be offered surgical resection of the middle lobe or lingula, which is associated with a low mortality rate and favorable outcome.

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Section: Treatment and Prognosis Of Mlssupporting

confidence: 91%