Presentation
A diagnosis of TBA presenting as MLS was made. To the best of our knowledge, this is the first detailed report of MLS as a presentation of TBA in the English literature. [ncbi.nlm.nih.gov]
Immune System
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Mediastinal Lymphadenopathy
Hilar and mediastinal lymphadenopathies were assessed on CT and MR images. RESULTS: Baseline CT detected consolidations in 100% of patients, bronchiectases in 35%, bronchial wall thickening in 53% and mucous plugging in 35%. [ncbi.nlm.nih.gov]
A computed tomography scan of the chest revealed significant narrowing of the right middle lobe bronchus with partial atelectasis and prominent calcified mediastinal lymphadenopathy (Figure 2). [swjpcc.com]
Investigation CT Chest right middle lobe bronchial thickening with distal collapse hilar mediastinal lymphadenopathy with suspicion of malignancy 7. InvestBronchscopy 8. Brochoscopy 9. [slideshare.net]
A computed tomography (CT) scan of the chest showed inhomogeneous opacities, as well as dilated airways crowded in the medial segment of the right middle lobe and inferior segment of the lingula, without mediastinal lymphadenopathy ( Box, B ). [mja.com.au]
Entire Body System
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Weight Loss
Case Report An 81-year-old retired schoolteacher presented with cough, shortness of breath, night sweats, and weight loss for 1 year that had worsened over the last 1 month. Middle lobe bronchiectasis had been documented by CT 3 years earlier. [academic.oup.com]
In our study most common symptoms were cough and difficult sputum expectoration followed by weight loss, haemoptysis, chest pain and dyspnea in frequency. [jtd.amegroups.com]
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Malaise
[…] of the middle lobe of the (right) lung, due to compression of the middle lobe bronchus, usually by enlarged lymph nodes, which may be tuberculous; chief symptoms are chronic cough, wheezing, recurrent respiratory infections, hemoptysis, chest pain, malaise [medical-dictionary.thefreedictionary.com]
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Fishing
[…] lobe bronchus Physiology Mechanism Extrinsic compression (by surrounding lymph nodes) or right middle lobe bronchus Intrinsic obstruction of the right middle lobe bronchus Defects in right middle lobe bronchial anatomy (which characteristically has a “fish [mdnxs.com]
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Pathologist
Tissue pathways for urological pathology The target primary users of the tissue pathway are trainee and consultant cellular pathologists. These recommendations will also be of value to trainee/qualified biomedical scientists involved in... [evidence.nhs.uk]
Respiratoric
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Cough
The most common clinical features were recurrent infection (n 15), chronic cough with productive sputum (n 9), chest pain (n 8) or dyspnea (n 7). [ncbi.nlm.nih.gov]
Our patient was a retired schoolteacher and considered it impolite to cough in public. She had a lifelong history of suppressing her cough. [academic.oup.com]
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Hemoptysis
The most common presenting symptoms were cough, dyspnea, fever, hemoptysis, and chest pain. Diagnostic studies included chest roentgenogram, bronchoscopy, and bronchography. Sixty-five patients had full recovery following intensive medical therapy. [ncbi.nlm.nih.gov]
Hemoptysis, chest pain, and dyspnea are also reported 1. [radiopaedia.org]
[…] with chronic pneumonitis of the middle lobe of the (right) lung, due to compression of the middle lobe bronchus, usually by enlarged lymph nodes, which may be tuberculous; chief symptoms are chronic cough, wheezing, recurrent respiratory infections, hemoptysis [medical-dictionary.thefreedictionary.com]
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Chronic Cough
Middle lobe syndrome, caused mainly by benign inflammatory diseases, such as chronic bronchitis and bronchiectasis, is manifested clinically as a chronic cough with sputum production. [ncbi.nlm.nih.gov]
Chronic cough. Diagnostic workout: Thoracic X-ray or CT scan. Bronchoscopy. Ventilatory and perfusion scintigraphy. [kidsdoc.at]
Otherwise, a chronic cough is the most common symptom. Hemoptysis, chest pain, and dyspnea are also reported 1. [radiopaedia.org]
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Pulmonary Disorder
Morris Lippincott Williams & Wilkins, 2005 - 647 من الصفحات The thoroughly revised, updated Sixth Edition of this Spiral Manual is a complete, convenient, practical guide to diagnosis and management of pulmonary disorders. [books.google.com]
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Chronic Productive Cough
CONCLUSION: MLS is more common in females, and recurrent infections, chronic productive cough and dyspnea were the most common symptoms. Bronchiectasis is the most common histological finding. [ncbi.nlm.nih.gov]
Jaw & Teeth
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Xerostomia
Primary Sjögren’s syndrome had been diagnosed in 2002, based on the presence of xerostomia, keratoconjunctivitis sicca, anti-Ro/La antibody, and rheumatoid factor, as well as a positive Schirmer’s test and the results of sialoscintigraphy. [mja.com.au]
Cardiovascular
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Chest Pain
The most common presenting symptoms were cough, dyspnea, fever, hemoptysis, and chest pain. Diagnostic studies included chest roentgenogram, bronchoscopy, and bronchography. Sixty-five patients had full recovery following intensive medical therapy. [ncbi.nlm.nih.gov]
pain, weight loss, and fever. [journals.lww.com]
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Left Ventricular Dysfunction
A two-dimensional echocardiogram showed aortic sclerosis and left ventricular dysfunction but no mitral valve prolapse. [academic.oup.com]
Musculoskeletal
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Bone Pain
A 63-year-old woman was admitted to our hospital with complaints of right iliac bone pain. She had been treated for chronic bronchitis and bronchiectasis associated with middle lobe syndrome for 16 years before admission. [ncbi.nlm.nih.gov]
Psychiatrical
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Suggestibility
The atelectasis responded well to glucocorticoid treatment, suggesting that the peribronchiolar lymphocytic infiltrates may have played an important role in the development of middle lobe syndrome in this patient. [ncbi.nlm.nih.gov]
Workup
[…] a chest radiograph is warranted in children with persistent or recurrent nonspecific respiratory symptoms, particularly if there is clinical deterioration, in order to detect middle lobe syndrome and to initiate a further diagnostic and therapeutic workup [ncbi.nlm.nih.gov]
Microbiology
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Mycobacterium Fortuitum
Fortuitum (see Mycobacterium Fortuitum ) Sjogren’s Syndrome (see Sjogren’s Syndrome ): lymphocytic bronchiolitis in the atelectatic lobes Streptococcus Pneumoniae (see Streptococcus Pneumoniae ): pediatric cases Tumor: with extrinsic compression or intrinsic [mdnxs.com]
Other Pathologies
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Lymphocytic Infiltrate
infiltrating the small airway walls. 7, 8 Local bronchial or bronchiolar lymphocyte infiltrates and inflammatory cell products may lead to impairment of tracheobronchial mucociliary clearance. 8, 9 In our patient, lymphocytic infiltrations in the terminal [mja.com.au]
The atelectasis responded well to glucocorticoid treatment, suggesting that the peribronchiolar lymphocytic infiltrates may have played an important role in the development of middle lobe syndrome in this patient. [ncbi.nlm.nih.gov]
Treatment
Medical treatment consists of bronchodilators, mucolytics, and antimicrobials. Patients whose disease is unresponsive to treatment and those with obstructive RML syndrome can be offered surgical treatment. [ncbi.nlm.nih.gov]
Prognosis
The prognosis associated with this syndrome is considered good in most cases which are caused by chronic inflammatory diseases. A patient who developed lung cancer in the course of long-term treatment for right middle lobe syndrome is described. [ncbi.nlm.nih.gov]
[…] is useful in excluding a cause of bronchial obstruction Middle lobe bronchus enters consolidated lobe in the posteromedial corner Differential Diagnosis Middle lobe pneumonia Treatment Depends on etiology Most are treated with medical therapy alone Prognosis [learningradiology.com]
The course and prognosis of endobronchial TB are variable, ranging from complete clearance to severe bronchostenosis ( 15 ). In this study, clinical, radiological and bronchoscopic characteristics of cases diagnosed to have EBTB were evaluated. [jtd.amegroups.com]
The authors conclude that the prognosis for successful retinal detachment repair in the Marfan Syndrome patients at the Wilmer Eye Institute is good regardless of whether the eye has had prior lens removal. [marfan.com.br]
Etiology
The etiology of MLS was initially described as external compression of the right middle lobe bronchus. However, it is known that multiple etiologies of MLS exist, involving intrinsic and extrinsic bronchial compression. [journals.lww.com]
Malignancy is the most common cause of the obstructive type, and infections are the second leading etiology. The nonobstructive type is associated with inflammatory conditions and bronchiectasis. [ncbi.nlm.nih.gov]
[…] include Inflammatory disease is the most common etiology In children, it is most common in association with asthma Malignant tumors (22%0 Bronchiectasis (15%) Tuberculosis (9%) Benign tumors (2%) In most cases, the etiology is never found Clinical Findings [learningradiology.com]
First described in the medical literature in 1948, [1] it is caused by various etiologies and has no consistent clinical definition. [emedicine.medscape.com]
Epidemiology
Epidemiology Frequency United States The precise incidence in children is unknown. Right middle lobe syndrome is widely underdiagnosed and frequently unrecognized. [emedicine.medscape.com]
Epidemiology Frequency United StatesThe precise incidence in children is unknown. Right middle lobe syndrome is widely underdiagnosed and frequently unrecognized. [thehealthscience.com]
Epidemiology, airway defense mechanisms, pathogenesis, imaging and genetic causes of bronchiectasis are discussed. Allergic bronchopulmonary aspergillosis is addressed, as well as non-tuberculous mycobacteria as a cause of bronchiectasis. [books.google.com]
Pathophysiology
A lack of collateral ventilation is a plausible theory to explain the pathophysiology in such patients. [ncbi.nlm.nih.gov]
There are two distinct types of pathophysiology- obstructive and non-obstructive. [swjpcc.com]
Prevention
This isolation prevents the aerating effects of collateral ventilation of the upper lobe from reaching the middle lobe and thus impairs the clearing of secretions from the middle lobe bronchus. [ncbi.nlm.nih.gov]
Prevention of bacterial endocarditis. الصفحة 303 - American Thoracic Society. Standards for the diagnosis and care of patients with chronic obstructive pulmonary disease (COPD) and asthma. [books.google.com]
Collaborative Meta-Analysis of Randomised Trials of Antiplatelet Therapy for Prevention of Death, Myocardial Infarction, and Stroke in High Risk Patients. [books.google.es]
B.A., Zhang, L., Villafranca, A., Karl, L., Kamal, S., Torres, B., o'Connor Michael (2011) Prevention of Intraoperative Awareness in a High-Risk Surgical Population. [scindeks.ceon.rs]