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Kim, Ma, Lee, Cho, Jeong, Jeon, Kim, Lee, and Hwang: Causes of Right Middle Lobe Syndrome -Recent Experience in Local Tertiary Hospital for Several Years-
Original Article
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2007; 62(3): 192-196.

Published online: 31 March 2007

DOI: https://doi.org/10.4046/trd.2007.62.3.192

Causes of Right Middle Lobe Syndrome -Recent Experience in Local Tertiary Hospital for Several Years-

Hyun Ok Kim, M.D.1, Jeong Eun Ma, M.D.1, Seung Jun Lee, M.D.1, Yu Ji Cho, M.D.1, Yi Yeong Jeong, M.D.1, Kyoung-Nyeo Jeon, M.D.2, Ho Cheol Kim, M.D.1, Jong Deok Lee, M.D.1, Young Sil Hwang, M.D.1

1Department of Internal Medicine, College of Medicine, Gyeongsang National University, Jinju, Korea.

2Department of Diagnostic Radiology, College of Medicine, Gyeongsang National University, Jinju, Korea.

Address for correspondence: Ho Cheol Kim, M.D. Department of Internal Medicine, Gyeongsang National University Hospital, 90 Chilam-dong, Jinju, Gyeongnam, 660-302, Korea. Phone: 82-55-750-8684, Fax: 82-55-758-9122, hochkim@gshp.gsnu.ac.kr

Received 15 January 2007       Accepted 6 March 2007

Copyright © 2007 The Korean Academy of Tuberculosis and Respiratory Diseases

Abstract

Background

Right middle lobe syndrome (RMLS) is defined as transient or chronic and recurrent atelectasis of the right middle lobe. Although numerous conditions are associated with RMLS, there are very few recent reports in Korea. This study evaluated the causes of RMLS in a local tertiary hospitalover a period of 42 months.

Methods

Eighty-eight patients (M:F=64:22, mean age: 67.2±10.3 years), who had consistent chest radiography findings and underwent bronchoscopy in Gyeongsang University Hospital from January 2003 to July 2006, were enrolled in this study. The clinical characteristics and causes of RMLS in these patients were retrospectively reviewed.

Results

The most common symptoms fo RMLS were cough, dyspnea and sputum. Tuberculosis was the most common cause (endobronchial tuberculosis in 22 and pulmonary tuberculosis in 1) The other causes were bronchial stenosis by benign fibrotic changes in 22 cases (25%), anthracofibrosis in 13 cases (14.8%), pneumonia in 11 cases (12.5%), lung cancer in 10 cases (11.4%), mucus impaction in 3 cases (3.4%), bronchiectasis in 2 cases (2.3%) and no demonstrable causes in 7 cases (8%). The bronchoscopy findings were mucosal edema with hyperemic changes in 38 cases (43.2%), mucosal edema with anthracotic pigmentation in 16 cases (18.2%), mucus impaction in 13 cases (14.8%), fibrotic stenosis in 13 cases (14.8%), a mass like lesion in 8 cases (9.1%), exudative necrotic material in 4 cases (4.5%), narrowing as a result of extrinsic compression in 2 cases (2.3%) and no demonstrable abnormalities in 12 cases (13.6%).

Conclusion

Right middle lobe syndrome was observed more frequently in patients over the age of 65. The causes were mainly benign diseases with endobronchial tuberculosis being the most common.

Keywords: Right middle lobe syndrome, Causes

Figures and Tables

Table 1
Clinical features in 88 patients with right middle lobe syndrome
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Table 2
Radiologic findings in 88 patients with right middle lobe syndrome
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Table 3
Bronchoscopic findings in 88 patients with right middle lobe syndrome
trd-62-192-i003
Table 4
Causes of right middle lobe syndrome in 88 patients
trd-62-192-i004

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