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Orta lob sendromlu olgularda bilgisayarlı tomografi bulguları

Year 2018, Volume: 28 Issue: 3, 96 - 101, 01.09.2018

Mesut Özgökçe Nuri Havan Süleyman Karabacak Ayşe Havan İlyas Dündar Fatma Durmaz İbrahim Üney Hanifi Yıldız Sümeyra Demirkol Alagöz Harun Aslan

Abstract

Amaç: Orta lob sendromu OLS , sağ akciğer orta lobunun kronik veya tekrarlayan atelektazileri ile karakterize bir tablodur. Spesifik bir klinik bulgusu yoktur. OLS tanısında Bilgisayarlı Tomografi BT en sık kullanılan modalitedir. Kliniğimizde son iki yılda OLS tanısı almış hastaların BT bulgularını literatür eşliğinde sunmayı amaçladık.Gereç ve Yöntem: Mayıs 2015- Mayıs 2017 tarihleri arasında hastanemiz radyoloji kliniğine başvuran ve OLS tanısı alan 29 hastanın, BT ve klinik bulguları retrospektif olarak iki radyolog ve bir göğüs hastalıkları uzmanı tarafından incelendi. Bulgular: OLS tanısı alan 29 hastanın 17’si %58,6 kadın, 12’si %41,4 erkek hastaydı. Kadın/erkek oranı 1.42 idi. Bu olguların yaş ortalaması ise 59,4±17,01 8-84 yaş olarak hesaplandı. Klinik değerlendirmede en sık semptom öksürük, nefes darlığı ve balgam olarak saptandı. Radyolojik görüntülemede tüm hastaların BT tetkiklerinde sağ akciğer orta lobda atelektazi mevcuttu. Atelektazi ile birlikte diğer en sık eşlik eden bulgular ise 11 hastada mediastinal ve/veya hiler patolojik görünümde lenfadenopati, 6 hastada bronşektazi, 4 hastada enfeksiyon ile uyumlu parankimal bulgular, 3 hastada parankimal nodüller, 3 hastada peribronşial kalınlaşma, 2 hastada operasyon sonrası değişiklikler, 2 hastada diafragmaevantrasyonu, 2 hastada mukus tıkacı, 1 hastada squamöz hücreli kanser, 1 hastada da pulmoneremboli idi. Dört hastada herhangi bir ek akciğer patolojisi saptanmadı. Sonuç: OLS, sağ akciğer orta lobun total atelektazisi olup spesifik klinik bulguları olmaması nedeniyle kronik ve tekrarlayan akciğer şikayetleri olan her hastada özellikle sağ akciğerde yerleşim gösteren lezyonlarda ayırıcı tanılar arasında göz önünde bulundurulmalıdır. BT’nin rutine girmesi ile de radyolojik olarak görülme sıklığı artmıştır. BT, OLS tanısında etkin ve noninvaziv bir görüntüleme yöntemidir

Keywords

Orta lob sendromu atelektazi bilgisayarlı tomografi

References

  • Gudbjartsson T, Gudmundsson G. Middle lobe syndrome: a review of clinicopathological features, diagnosis and tre- atment. Respiration 2012;84:80-6.
  • Brock RC, Cann RJ, Dickinson JR. Tuberculous mediastinal lymphadenitis in childhood; secondary effects on the lungs. Guy’s Hosp Rep 1937;87:295-317.
  • Graham EA, Burford TH, Mayer JH. Middle lobe syndro- me. Post Grad Med 1948;4(1):29-34.
  • Culiner MM. The right middle lobe syndrome, a nonobst- ructive complex. Dis Chest 1966;50:57-66.
  • Wagner RB, Johnston MR. Middle lobe syndrome. Ann Thorac Surg 1983;35:679-86.
  • Ayed AK. Resection of the right middle lobe and lingu- la in children for middle lobe/lingula syndrome. Chest 2004;125:38-42.
  • Priftis KN, Mermiri D, Papadopoulou A, Anthracopoulos MB, Vaos G, Nicolaidou P. The role of timely intervention in middle lobe syndrome in children. Chest 2005;128:2504– 10.
  • Livingston GL, Holinger LD, Luck SR. Right middle lobe syndrome in children. Int J Pediatr Otorhinolaryngol 1987;13: 11–23.
  • Miyazaki A, Ashizawa K, Mori M, Ohtsubo M. Right midd- le lobe atelectasis: Chest radiographic and CT appearances correlating with the clinical features. Acta Med Nagasakien- sia 2003;48: 159–66.
  • Rashid, A., Nanjappa, S., & Greene, J. N. Infectious Cau- ses of Right Middle Lobe Syndrome. Cancer Control 2017; 24(1): 60-6.
  • Kwon KY, Myers JL, Swensen SJ, et al. Middle lobe syndro- me: a clinicopathological study of 21 patients. Hum Path 1995;26(3):302-7.
  • Rosenbloom SA, Ravin CE, Putman CE, et al. Peripheral middle lobe syndrome. Radiology 1983;149(1):17-21.
  • Romagnoli V, Priftis KN, de Benedictis FM. Middle lobe sy- ndrome in children today. Paediatr Respir Rev 2014;15:188- 93.
  • Bertelsen S, Struve-Christensen E, Aasted A, Sparup J. Iso- lated middle lobe atelectasis: aetiology, pathogenesis, and treatment of the so-called middle lobe syndrome. Thorax 1980;35:449-52.
  • Einarsson JT, Einarsson JG, Isaksson H, Gudbjartsson T, Gudmundsson G. Middle lobe syndrome: a nation wide study on clinicopathological features and surgical treat- ment. Clin Respir J 2009;3:77-81.
  • Dees SC, Spock A. Right middle lobe syndrome in children. JAMA 1966;197:8-14.
  • Meteroğlu F, Şahin A, Sevval E. T. Middle lobe syndrome: a retrospective analysis. Türk Göğüs Kalp Damar Cerrahisi Dergisi 2013; 21(3): 718-22.
  • McElvein RB, Mayo P. Middle lobe disease. South Med J 1967;60:1029-32.
  • Kartaloğlu Z. Orta lob sendromu. Türk Göğüs Kalp Damar Cerrahisi Dergisi 2016;24(1):178-84.
  • M.S Parker, M.L. Rosado-de- Christenson, G. F. Abott. Te- aching Atlas of Chest Imaging Habitat and Thieme. 2005; 206-9.
  • Fraioli F, Serra G, Ciarlo G, Massaccesi V, Liberali S, Fio- 101 relli A, et al. Chest MR imaging in the follow-up of pulmonary alterations in paediatric patients with middle lobe syndrome: comparison with chest X-ray. Radiol Med 2013;118:444-55.
  • Rock MJ. The diagnosticutility of broncho alveolar lavage in immunocompetent children with unexplained infiltrates on chest radiograph. Pediatrics 1995;95:373-7.
  • Kala J, Sahay S, Shah A. Bronchial anthracofibrosis and tuberculosis presenting as a middle lobe syndrome. Prim Care Respir J 2008;17:51-5.
  • Doğan R, Alp M, Kaya S, Ayrancioğlu K, Taştepe I, Unlü M, et al. Surgical treatment of bronchiectasis: a collective review of 487 cases. Thorac Cardiovasc Surg 1989;37:183-6.
  • O’Donnell AE. Bronchiectasis. Chest 2008;134:815-23

Year 2018, Volume: 28 Issue: 3, 96 - 101, 01.09.2018

Mesut Özgökçe Nuri Havan Süleyman Karabacak Ayşe Havan İlyas Dündar Fatma Durmaz İbrahim Üney Hanifi Yıldız Sümeyra Demirkol Alagöz Harun Aslan

Abstract

Objective: Middle lobe syndrome MLS is a condition characterized by chronic or recurrent atelectasis of the right middle lobe of the lung. There is nonspecific clinical finding. Computed Tomography CT is the most commonly used modality in MLS diagnosis. We Aimed To Present The CT findings of : patients who have been diagnosed MLS in our clinic for the past two years with literature.Materials and Method: Between May 2015 and May 2017, CT and clinic findings of 29 patients who are diagnosed MLS reviewed retrospectively by two cardiologist and a chest diseases doctor.Results: 17 of the 29 patients 58,6% were female and 12 41,4% were male who are diagnosed with MLS. Female/male ratio was 1,42. The Mean Age of these cases was 59,4 ± 17,01 8-84 age range . In Clinical Assessment The Most Common Symptoms Were Cough, shortness ofbreath and sputum. Radiologically, all patients had atelectasis in the right middle lobe of lung at the CT examination. The Most Common Accompanying Findings with atelectasis were mediastinum and/or hilar lymphadenopathy in 11 patients, bronchiectasis in 6 patients, parenchymal findings compatible with infection in 4 patients. Any Lung Pathology Wasn't detected in 4 patients.Conclusion: MLS is a total atelectasis of the middle lobe of right lung and there is nonspecific clinical findings. İt Should be absolutely considered among the differential diagnosis in patients with chronic and recurrent lung complaints, especially in the located lesions that in right lung. The frequency of radiological appearance increased with the routinizing of CT. CT is an effective and non-invasive imaging method for diagnosis of MLS

Keywords

Middle lobe syndrome atelectasis computed tomography

References

  • Gudbjartsson T, Gudmundsson G. Middle lobe syndrome: a review of clinicopathological features, diagnosis and tre- atment. Respiration 2012;84:80-6.
  • Brock RC, Cann RJ, Dickinson JR. Tuberculous mediastinal lymphadenitis in childhood; secondary effects on the lungs. Guy’s Hosp Rep 1937;87:295-317.
  • Graham EA, Burford TH, Mayer JH. Middle lobe syndro- me. Post Grad Med 1948;4(1):29-34.
  • Culiner MM. The right middle lobe syndrome, a nonobst- ructive complex. Dis Chest 1966;50:57-66.
  • Wagner RB, Johnston MR. Middle lobe syndrome. Ann Thorac Surg 1983;35:679-86.
  • Ayed AK. Resection of the right middle lobe and lingu- la in children for middle lobe/lingula syndrome. Chest 2004;125:38-42.
  • Priftis KN, Mermiri D, Papadopoulou A, Anthracopoulos MB, Vaos G, Nicolaidou P. The role of timely intervention in middle lobe syndrome in children. Chest 2005;128:2504– 10.
  • Livingston GL, Holinger LD, Luck SR. Right middle lobe syndrome in children. Int J Pediatr Otorhinolaryngol 1987;13: 11–23.
  • Miyazaki A, Ashizawa K, Mori M, Ohtsubo M. Right midd- le lobe atelectasis: Chest radiographic and CT appearances correlating with the clinical features. Acta Med Nagasakien- sia 2003;48: 159–66.
  • Rashid, A., Nanjappa, S., & Greene, J. N. Infectious Cau- ses of Right Middle Lobe Syndrome. Cancer Control 2017; 24(1): 60-6.
  • Kwon KY, Myers JL, Swensen SJ, et al. Middle lobe syndro- me: a clinicopathological study of 21 patients. Hum Path 1995;26(3):302-7.
  • Rosenbloom SA, Ravin CE, Putman CE, et al. Peripheral middle lobe syndrome. Radiology 1983;149(1):17-21.
  • Romagnoli V, Priftis KN, de Benedictis FM. Middle lobe sy- ndrome in children today. Paediatr Respir Rev 2014;15:188- 93.
  • Bertelsen S, Struve-Christensen E, Aasted A, Sparup J. Iso- lated middle lobe atelectasis: aetiology, pathogenesis, and treatment of the so-called middle lobe syndrome. Thorax 1980;35:449-52.
  • Einarsson JT, Einarsson JG, Isaksson H, Gudbjartsson T, Gudmundsson G. Middle lobe syndrome: a nation wide study on clinicopathological features and surgical treat- ment. Clin Respir J 2009;3:77-81.
  • Dees SC, Spock A. Right middle lobe syndrome in children. JAMA 1966;197:8-14.
  • Meteroğlu F, Şahin A, Sevval E. T. Middle lobe syndrome: a retrospective analysis. Türk Göğüs Kalp Damar Cerrahisi Dergisi 2013; 21(3): 718-22.
  • McElvein RB, Mayo P. Middle lobe disease. South Med J 1967;60:1029-32.
  • Kartaloğlu Z. Orta lob sendromu. Türk Göğüs Kalp Damar Cerrahisi Dergisi 2016;24(1):178-84.
  • M.S Parker, M.L. Rosado-de- Christenson, G. F. Abott. Te- aching Atlas of Chest Imaging Habitat and Thieme. 2005; 206-9.
  • Fraioli F, Serra G, Ciarlo G, Massaccesi V, Liberali S, Fio- 101 relli A, et al. Chest MR imaging in the follow-up of pulmonary alterations in paediatric patients with middle lobe syndrome: comparison with chest X-ray. Radiol Med 2013;118:444-55.
  • Rock MJ. The diagnosticutility of broncho alveolar lavage in immunocompetent children with unexplained infiltrates on chest radiograph. Pediatrics 1995;95:373-7.
  • Kala J, Sahay S, Shah A. Bronchial anthracofibrosis and tuberculosis presenting as a middle lobe syndrome. Prim Care Respir J 2008;17:51-5.
  • Doğan R, Alp M, Kaya S, Ayrancioğlu K, Taştepe I, Unlü M, et al. Surgical treatment of bronchiectasis: a collective review of 487 cases. Thorac Cardiovasc Surg 1989;37:183-6.
  • O’Donnell AE. Bronchiectasis. Chest 2008;134:815-23
There are 25 citations in total.

Details

Primary Language Turkish
Journal Section Original Article
Authors

Mesut Özgökçe This is me

Nuri Havan This is me

Süleyman Karabacak This is me

Ayşe Havan This is me

İlyas Dündar This is me

Fatma Durmaz This is me

İbrahim Üney This is me

Hanifi Yıldız This is me

Sümeyra Demirkol Alagöz This is me

Harun Aslan This is me

Publication Date September 1, 2018
Published in Issue Year 2018 Volume: 28 Issue: 3

Cite

Vancouver Özgökçe M, Havan N, Karabacak S, Havan A, Dündar İ, Durmaz F, Üney İ, Yıldız H, Alagöz SD, Aslan H. Orta lob sendromlu olgularda bilgisayarlı tomografi bulguları. Genel Tıp Derg. 2018;28(3):96-101.

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