Skip to main content
Top
Published in:

Open Access 08-08-2024 | Respiratory Medicine | Case report

Swyer–James–Macleod syndrome mimicking pulmonary embolism in adults: a case report

Authors: Girma Deshimo Lema, Ermiyas Endewunet Melaku, Haile Abebe Tekle, Getachew Bizuneh Aydagnuhm, Enguday Demeke Gebeyaw

Published in: Journal of Medical Case Reports | Issue 1/2024

Login to get access

Abstract

Background

Swyer–James–MacLeod syndrome (SJMS) is a rare lung condition characterized by a unilateral lung hyperlucency and reduction in the pulmonary vasculature, with or without the presence of bronchiectasis. In the 1950s, Swyer, James, and Macleod simultaneously characterized the syndrome for the first time. It is typically diagnosed in childhood. Adult-onset cases are extremely rare, with little literature available on its clinical presentation and diagnostic challenges. Swyer–James–MacLeod syndrome can mimic other lung disorders, resulting in misdiagnosis and improper treatment.

Case presentation

A 49- year-old woman from Debre Berhan, Ethiopia, presented to the emergency department of Hakim Gizaw Teaching Hospital with symptoms and radiographic findings mimicking acute pulmonary embolism. On the basis of the clinical presentation and radiographic findings, the patient was first treated as a probable case of pulmonary embolism. Anticoagulant therapy and oxygen support were initiated. Nevertheless, additional testing using a chest computed tomography angiography revealed left lung hyperlucency, decreased vascularity, bronchiectasis, and a negative result for pulmonary embolism. As a result, Swyer–James–MacLeod syndrome was diagnosed.

Conclusion

The symptoms of Swyer–James–MacLeod syndrome can be mistaken for pulmonary embolism, which could lead to ineffective treatment and needless expenses. In individuals presenting with symptoms suggestive of pulmonary embolism, this case emphasizes the significance of considering Swyer–James–MacLeod syndrome as a differential diagnosis, especially in the absence of established risk factors for pulmonary embolism.
Literature
1.
go back to reference Ohri SK, Rutty G, Fountain SW. Acquired segmental emphysema: the enlarging spectrum of Swyer-James/Macleod’s syndrome. Ann Thorac Surg. 1993;56(1):120–4.CrossRefPubMed Ohri SK, Rutty G, Fountain SW. Acquired segmental emphysema: the enlarging spectrum of Swyer-James/Macleod’s syndrome. Ann Thorac Surg. 1993;56(1):120–4.CrossRefPubMed
2.
go back to reference Lucaya J, Gartner S, García-Peña P, Cobos N, Roca I, Liñan S. Spectrum of manifestations of Swyer-James-MacLeod syndrome. J Comput Assist Tomogr. 1998;22(4):592–7.CrossRefPubMed Lucaya J, Gartner S, García-Peña P, Cobos N, Roca I, Liñan S. Spectrum of manifestations of Swyer-James-MacLeod syndrome. J Comput Assist Tomogr. 1998;22(4):592–7.CrossRefPubMed
5.
go back to reference Behrendt A, Lee Y. Swyer-James-Macleod syndrome. StatPearls: StatPearls Publishing; 2022. Behrendt A, Lee Y. Swyer-James-Macleod syndrome. StatPearls: StatPearls Publishing; 2022.
6.
go back to reference Sen HS, Taylan M, Abakay O, Sezgi C, Cetincakmak MG. Adult diagnosis of Swyer-James-Macleod syndrome: retrospective analysis of four cases. Respir Care. 2014;59(4):e51–4.CrossRefPubMed Sen HS, Taylan M, Abakay O, Sezgi C, Cetincakmak MG. Adult diagnosis of Swyer-James-Macleod syndrome: retrospective analysis of four cases. Respir Care. 2014;59(4):e51–4.CrossRefPubMed
7.
go back to reference Abba AA, Al-Mobeireek AF. Clinical spectrum of Swyer-James-Macleod syndrome in adults. Saudi Med J. 2003;24(2):195–8.PubMed Abba AA, Al-Mobeireek AF. Clinical spectrum of Swyer-James-Macleod syndrome in adults. Saudi Med J. 2003;24(2):195–8.PubMed
8.
go back to reference Dirweesh A, Alvarez C, Khan M, Shah N. A unilateral hyperlucent lung-Swyer-James syndrome: a case report and literature review. Respir Med Case Rep. 2017;20:104–6.PubMedPubMedCentral Dirweesh A, Alvarez C, Khan M, Shah N. A unilateral hyperlucent lung-Swyer-James syndrome: a case report and literature review. Respir Med Case Rep. 2017;20:104–6.PubMedPubMedCentral
9.
go back to reference Khalil KF, Saeed W. Swyer-James-Macleod syndrome. J College Phys Surg Pakistan. 2008;18(3):190–2. Khalil KF, Saeed W. Swyer-James-Macleod syndrome. J College Phys Surg Pakistan. 2008;18(3):190–2.
10.
go back to reference Mehra S, Basnayake T, Falhammar H, Heraganahally S, Tripathi S. Swyer–James–MacLeod syndrome—a rare diagnosis presented through two adult patients. Respirol Case Rep. 2017;5(5): e00245.CrossRefPubMedPubMedCentral Mehra S, Basnayake T, Falhammar H, Heraganahally S, Tripathi S. Swyer–James–MacLeod syndrome—a rare diagnosis presented through two adult patients. Respirol Case Rep. 2017;5(5): e00245.CrossRefPubMedPubMedCentral
11.
go back to reference da Silva PSL, Lopes R, Neto HM. Swyer-James-MacLeod syndrome in a surgically treated child: a case report and brief literature review. J Pediatr Surg. 2012;47(4):e17–22.CrossRefPubMed da Silva PSL, Lopes R, Neto HM. Swyer-James-MacLeod syndrome in a surgically treated child: a case report and brief literature review. J Pediatr Surg. 2012;47(4):e17–22.CrossRefPubMed
12.
go back to reference Coche E, Verschuren F, Hainaut P, Goncette L. Pulmonary embolism findings on chest radiographs and multislice spiral CT. Eur Radiol. 2004;14:1241–8.CrossRefPubMed Coche E, Verschuren F, Hainaut P, Goncette L. Pulmonary embolism findings on chest radiographs and multislice spiral CT. Eur Radiol. 2004;14:1241–8.CrossRefPubMed
13.
go back to reference Westermark N. On the roentgen diagnosis of lung embolism. Acta Radiol. 1938;4:357–72. Westermark N. On the roentgen diagnosis of lung embolism. Acta Radiol. 1938;4:357–72.
14.
go back to reference Algin O, Gökalp G, Topal U. Signs in chest imaging. Diagn Interv Radiol. 2011;17(1):18.PubMed Algin O, Gökalp G, Topal U. Signs in chest imaging. Diagn Interv Radiol. 2011;17(1):18.PubMed
15.
go back to reference Marshall GB, Farnquist BA, MacGregor JH, Burrowes PW. Signs in thoracic imaging. J Thorac Imaging. 2006;21(1):76–90.CrossRefPubMed Marshall GB, Farnquist BA, MacGregor JH, Burrowes PW. Signs in thoracic imaging. J Thorac Imaging. 2006;21(1):76–90.CrossRefPubMed
16.
go back to reference Girardi AM, Bettiol RS, Garcia TS, Ribeiro GL, Rodrigues ÉM, Gazzana MB, et al. Wells and Geneva scores are not reliable predictors of pulmonary embolism in critically ill patients: a retrospective study. J Intensive Care Med. 2020;35(10):1112–7.CrossRefPubMed Girardi AM, Bettiol RS, Garcia TS, Ribeiro GL, Rodrigues ÉM, Gazzana MB, et al. Wells and Geneva scores are not reliable predictors of pulmonary embolism in critically ill patients: a retrospective study. J Intensive Care Med. 2020;35(10):1112–7.CrossRefPubMed
17.
go back to reference Dresden S, Mitchell P, Rahimi L, Leo M, Rubin-Smith J, Bibi S, et al. Right ventricular dilatation on bedside echocardiography performed by emergency physicians aids in the diagnosis of pulmonary embolism. Ann Emerg Med. 2014;63(1):16–24.CrossRefPubMed Dresden S, Mitchell P, Rahimi L, Leo M, Rubin-Smith J, Bibi S, et al. Right ventricular dilatation on bedside echocardiography performed by emergency physicians aids in the diagnosis of pulmonary embolism. Ann Emerg Med. 2014;63(1):16–24.CrossRefPubMed
18.
go back to reference Klok FA, Mos IC, Kroft LJ, de Roos A, Huisman MV. Computed tomography pulmonary angiography as a single imaging test to rule out pulmonary embolism. Curr Opin Pulm Med. 2011;17(5):380–6.CrossRefPubMed Klok FA, Mos IC, Kroft LJ, de Roos A, Huisman MV. Computed tomography pulmonary angiography as a single imaging test to rule out pulmonary embolism. Curr Opin Pulm Med. 2011;17(5):380–6.CrossRefPubMed
19.
go back to reference Akgedik R, Karamanli H, Aytekin İ, Kurt AB, Öztürk H, Dağlı CE. Swyer–James–Macleod syndrome mimicking an acute pulmonary embolism: a report of six adult cases and a retrospective analysis. Clin Respir J. 2018;12(2):404–9.CrossRefPubMed Akgedik R, Karamanli H, Aytekin İ, Kurt AB, Öztürk H, Dağlı CE. Swyer–James–Macleod syndrome mimicking an acute pulmonary embolism: a report of six adult cases and a retrospective analysis. Clin Respir J. 2018;12(2):404–9.CrossRefPubMed
20.
go back to reference Fregonese L, Girosi D, Battistini E, Fregonese B, Risso FM, Bava GL, et al. Clinical, physiologic, and roentgenographic changes after pneumonectomy in a boy with Macleod/Swyer-James syndrome and bronchiectasis. Pediatr Pulmonol. 2002;34(5):412–6.CrossRefPubMed Fregonese L, Girosi D, Battistini E, Fregonese B, Risso FM, Bava GL, et al. Clinical, physiologic, and roentgenographic changes after pneumonectomy in a boy with Macleod/Swyer-James syndrome and bronchiectasis. Pediatr Pulmonol. 2002;34(5):412–6.CrossRefPubMed
21.
go back to reference Koyama T, Osada H, Kitanaka Y, Funaki S, Hiekata T. Surgically treated Swyer-James syndrome. Jpn J Thorac Cardiovasc Surg. 2001;49:671–4.CrossRefPubMed Koyama T, Osada H, Kitanaka Y, Funaki S, Hiekata T. Surgically treated Swyer-James syndrome. Jpn J Thorac Cardiovasc Surg. 2001;49:671–4.CrossRefPubMed
22.
go back to reference Yekeler E. A rare case of swyer-james macleod syndrome and a new clinical presentation, acquired lobar emphysema. Ann Thorac Surg. 2012;93(5):e123–5.CrossRefPubMed Yekeler E. A rare case of swyer-james macleod syndrome and a new clinical presentation, acquired lobar emphysema. Ann Thorac Surg. 2012;93(5):e123–5.CrossRefPubMed
23.
go back to reference Daniel TL, Woodring JH, Mac Vandiviere H, Wilson HD. Swyer-James syndrome—unilateral hyperlucent lung syndrome: a case report and review. Clin Pediatr. 1984;23(7):393–7.CrossRef Daniel TL, Woodring JH, Mac Vandiviere H, Wilson HD. Swyer-James syndrome—unilateral hyperlucent lung syndrome: a case report and review. Clin Pediatr. 1984;23(7):393–7.CrossRef
Metadata
Title
Swyer–James–Macleod syndrome mimicking pulmonary embolism in adults: a case report
Authors
Girma Deshimo Lema
Ermiyas Endewunet Melaku
Haile Abebe Tekle
Getachew Bizuneh Aydagnuhm
Enguday Demeke Gebeyaw
Publication date
08-08-2024
Publisher
BioMed Central
Published in
Journal of Medical Case Reports / Issue 1/2024
Electronic ISSN: 1752-1947
DOI
https://doi.org/10.1186/s13256-024-04680-3

Other articles of this Issue 1/2024

Journal of Medical Case Reports 1/2024 Go to the issue
SPONSORED

Targeting COPD with type 2 inflammation: emerging biologic landscape

  • Live
  • Webinar | 03-12-2024 | 19:00 (CET)

LIVE: Tuesday, 3 December 2024, 19:00-20:30 (CET)

Join us for an insightful session tailored for pulmonologists and healthcare professionals eager to enhance their understanding of COPD and the latest advances in biologic therapies. 

Sponsored by:
  • Sanofi
Developed by: Springer Healthcare
Reserve your place

A quick guide to ECGs

Improve your ECG interpretation skills with this comprehensive, rapid, interactive course. Expert advice provides detailed feedback as you work through 50 ECGs covering the most common cardiac presentations to ensure your practice stays up to date. 

PD Dr. Carsten W. Israel
Developed by: Springer Medizin
Start the cases