Source: Annual Congress 2003 - Clinical features in tuberculosis - I
Disease area: Respiratory infections

Abstract

Middle lobe syndrome (MLS) is defined as the middle lobe collapse, sometimes due to endobronchial obstruction or to external bronchial compression.
The aim of the study was to analyze the etiology of MLS in adults.
In 2002 we evaluated 33 patients (pts) with MLS, 22 men (mean age 64.0 years, range from 50-77) and 11 women (mean age 67.3 years, range from 56-77). The clinical, bronchoscopic, histologic and bacteriologic findings were analyzed respectively.
Cough was the most common symptom (28/33), mainly dry; 13/33 pts had fever; dyspnea was present in 13/33 pts; thoracic pain in 11/33 pts; haemoptysis in 8/33 pts; there was one patient with no symptom.
Fiberoptic bronhoscopy identified contracting scars in 15 pts (anthracofibrosis was found in 10), infiltrating neoplasm in 9 pts, endobronchial mass in 5 pts, oedema and erythema in 2 pts. Two pts had normal bronchoscopic appearance. The diagnosis was confirmed by histologic examination in 16/33 pts (lung cancer in 14, tuberculosis (TB) in one, pneumonia in 1 pt). M. tuberculosis was identified in 3 pts by examination of sputum smears and cultures.
The etiology of MLS was confirmed due to clinical features and all performed analyzes. Fourteen (42.4%) cases were diagnosed as lung cancer, 7 (21.2%) cases as pneumonia, 3 (9.1%) cases as active TB. There were contracting scars in 9 (27,3%) pts who suffered from TB in past.
According to our results, the chief cause of MLS is lung cancer. In our population TB is still an important cause of MLS.

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Citations should be made in the following way:
T. S. Cvok, B. Milenkovic, E. Sudjic, T. T. Cvok (Belgrade, Yugoslavia). Middle lobe syndrome in adults. Eur Respir J 2003; 22: Suppl. 45, 998

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