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Swyer-James-MacLeod syndrome — SCE Respiratory MCQ

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HardImagingSwyer-James-MacLeod syndromeSCE Respiratory

A 35-year-old man has exertional dyspnoea years after severe childhood adenovirus pneumonia. Chest radiograph shows a small hyperlucent left lung with reduced vascular markings. CT confirms air trapping and bronchiectasis without pulmonary embolus. Perfusion scan shows reduced perfusion to the affected lung. What is the most likely diagnosis?

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Correct answer: A — Swyer-James-MacLeod syndrome

Post-infectious unilateral hyperlucent small lung with air trapping and reduced perfusion suggests Swyer-James-MacLeod syndrome. Acute PE can cause oligemia but would not explain the chronic small lung and bronchiectasis. Childhood severe infection is a key historical clue.

Reference: Fleischner Society thoracic imaging glossary; ERS small airways disease resources