Right middle lobe syndrome

Last revised by Henry Knipe on 9 Nov 2022

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. Haemoptysis, chest pain, and dyspnoea have also been reported 1.  

Right middle lobe syndrome can be categorised into two types:

The underlying aetiology 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

The radiographic features of right middle lobe syndrome are a combination of:

Right middle lobe syndrome was first identified clinically in 1948 by Graham et al. 

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