A Rare Case of Swyer James Syndrome

AIMS& OBJECTIVES: To review the clinical presentation and imaging findings in a rare case of Swyer James Syndrome MATERIALS& METHODS: A 50 year old male patient presented with complaints of exertional dyspnea, cough with expectoration for the past three months. Detailed history revealed similar dyspnea episodes since childhood. RESULT: Patient underwent HRCT Thorax which revealed unilateral radiolucency in the left lower lobe with decreased vascularity with associated bronchiectasis and nodular opacities. Mosaic attenuation pattern with air trapping on expiratory scan was also seen. CONCLUSION: SJMS is considered to be a relatively uncommon and complex disease characterized by unilateral hyperlucency of a part of or the entire lung which was first described in 1953 by Swyer and James. Some patients, who have little or no associated sequelae bronchiectasis, have minor symptoms or are asymptomatic and may, therefore, not be diagnosed until they are adults. SJMS diagnosis is based on the radiological pattern such as unilateral or lobar pulmonary hyperlucency associated with an air trapping lung during expiration ultimately resembling a mosaic pattern. The affected lung parenchyma shows a variable degree of destruction and bronchiectasis could be associated. The diagnosis of this syndrome is better established with HRCT on inspiration and expiration complemented with an angio-CT