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Case Reports
. 2024 Aug 8;18(1):359.
doi: 10.1186/s13256-024-04680-3.

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

Girma Deshimo Lema  1 , Ermiyas Endewunet Melaku  2 , Haile Abebe Tekle  3 , Getachew Bizuneh Aydagnuhm  2 , Enguday Demeke Gebeyaw  4
Affiliations
Case Reports

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

Girma Deshimo Lema et al. J Med Case Rep. .

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.

Keywords: Adult onset; Bronchiectasis; Lung hyperlucency; Pulmonary embolism; Swyer–James–MacLeod syndrome.

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Conflict of interest statement

The authors declare that there are no competing interests.

Figures

Fig. 1
Fig. 1
Posteroanterior view of chest X-ray showing left upper lobe hyperlucency and ipsilateral small hila
Fig. 2
Fig. 2
The electrocardiogram showing sinus tachycardia and T wave inversions in leads V1–V3
Fig. 3
Fig. 3
Chest computed tomography showed left lung hyperluceny and bronchiectasis
Fig. 4
Fig. 4
Chest angio-computed tomography (mediastinal window) displaying left pulmonary artery (L) hypoplasia
Fig. 5
Fig. 5
Chest computed tomography showing diffuse cystic bronchiectasis in the left lung
See this image and copyright information in PMC

References

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