Citation, DOI, disclosures and article data
Citation:
Gaillard F, Knipe H, Glick Y, et al. Right middle lobe syndrome. Reference article, Radiopaedia.org (Accessed on 24 Apr 2024) https://doi.org/10.53347/rID-15352
Disclosures:
At the time the article was last revised Henry Knipe had the following disclosures:
- Radiopaedia Events Pty Ltd, Speaker fees (past)
- Integral Diagnostics, Shareholder (ongoing)
- Micro-X Ltd, Shareholder (ongoing)
These were assessed during peer review and were determined to
not be relevant to the changes that were made.
View Henry Knipe's current disclosures
Right middle lobe syndrome refers to chronic right middle lobe collapse, usually without an obstructing lesion (but not always). It is usually with associated bronchiectasis.
Right middle lobe syndrome is usually encountered in older adults, with a predilection for women (see Lady Windermere syndrome). It is also seen in children 1.
In most cases, patients are asymptomatic. Otherwise, a chronic cough can be a common symptom. Hemoptysis, chest pain, and dyspnea have also been reported 1.
Right middle lobe syndrome can be categorized into two types:
The underlying etiology of right middle lobe syndrome remains poorly understood, but poor collateral ventilation, a relatively narrow ostium, and infection/inflammation are all thought to play a role 3. The histological processes identified in such cases include 1:
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The radiographic features of right middle lobe syndrome are a combination of:
History and etymology
Right middle lobe syndrome was first identified clinically in 1948 by Graham et al.
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1. Wallace Miller. Diagnostic Thoracic Imaging. (2006) ISBN: 0071413006 - Google Books
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2. W. Richard Webb, Charles B. Higgins. Thoracic Imaging. (2010) ISBN: 9781605479767 - Google Books
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3. De Boeck K, Willems T, Van Gysel D, Corbeel L, Eeckels R. Outcome After Right Middle Lobe Syndrome. Chest. 1995;108(1):150-2. doi:10.1378/chest.108.1.150 - Pubmed
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4. Kwon K, Myers J, Swensen S, Colby T. Middle Lobe Syndrome: A Clinicopathological Study of 21 Patients. Hum Pathol. 1995;26(3):302-7. doi:10.1016/0046-8177(95)90062-4 - Pubmed
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5. Chen H, Lai S, Kwang W, Liu J, Chen C, Huang D. Middle Lobe Syndrome as the Pulmonary Manifestation of Primary Sjögren's Syndrome. Med J Aust. 2006;184(6):294-5. doi:10.5694/j.1326-5377.2006.tb00242.x - Pubmed
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6. Gudbjartsson T & Gudmundsson G. Middle Lobe Syndrome: A Review of Clinicopathological Features, Diagnosis and Treatment. Respiration. 2012;84(1):80-6. doi:10.1159/000336238 - Pubmed
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