Congenital lobar overinflation

Case contributed by Hoe Han Guan


Cough and runny nose with fever and respiratory distress for 3 days.

Patient Data

Age: 3 months
Gender: Female

Area of hyperlucency with oligemia at the right middle and lower lung zones.
Mass effect and mediastinal shift to the left side.
Bilateral upper lung zones consolidation.

The right middle lung lobe is overdistended/hyperinflated with diffuse hypo-attenuated pattern associated with mildly attenuated vascularity as well as mediastinal shift to the left. The right upper lobe is completely collapsed with air bronchogram.

Subsegmental atelectasis of the apicoposterior segment of left upper lobe. No endobronchial lesion or mucus plugging. 

Case Discussion

Imaging features are in keeping with congenital lobar overinflation. Surgical lobectomy performed as patient has worsening respiratory distress.

Congenital lobar overinflation, previously called congenital lobar emphysema, is a congenital lung abnormality that appears on chest x-rays as a hyperlucent lung segment and contralateral mediastinal shift. 

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