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Case Reports
. 2015 Dec 7;8(1):812.
doi: 10.2484/rcr.v8i1.812. eCollection 2013.

Spontaneous middle-lobe torsion

Tyler Ternes, Matthew Trump, Melissa Rosado de Christenson, Gregory Howell, James Stewart
Case Reports

Spontaneous middle-lobe torsion

Tyler Ternes et al. Radiol Case Rep. .

Abstract

Middle-lobe torsion is a well documented but rare entity that typically occurs following surgery, characteristically after right-upper lobectomy. It has also been described in the setting of pleural effusion, trauma, and neoplasm. We present a case of spontaneous middle-lobe torsion, occurring in the absence of the above risk factors, with emphasis on radiographic and CT findings.

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Figures

Figure 1
Figure 1
28-year-old male with middle-lobe torsion. PA (A) and lateral (B) chest radiographs demonstrate a subtle right-upper-lung zone suprahilar opacity and left-upper-lobe atelectasis associated with a luftsichel sign.
Figure 2
Figure 2
28-year-old male with middle-lobe torsion. Axial (A) and sagittal (B) unenhanced chest CT (lung window) shows atelectatic lung (arrow) positioned between the posterior segment of the right upper lobe and superior segment of the right lower lobe.
Figure 3
Figure 3
28-year-old male with middle-lobe torsion. Coronal (A) and sagittal (B) oblique minimu- intensity-projection (MinIP) images illustrate to better advantage the path of the narrowed middle-lobe bronchus (arrowhead). Note its course below the right interlobar pulmonary artery (*) and subsequent cranial and posterior course of the bronchi, confirming torsion of the middle lobe.
See this image and copyright information in PMC

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