Unilateral hyperlucent lung in a child caused by a foreign body identified with v/q scintigraphy.
A 5-year-old girl presented with episodes of coughing, inspiratory stridor, and occasionally squeaking breath sounds. There was no history of a foreign body aspiration. Initially, she was diagnosed with allergic asthma. However, signs and symptoms continued despite a trial of inhaled corticosteroids. A chest radiograph showed a hyperlucent right lung, mainly in the upper lobe, with decreased vascular markings compatible with Swyer-James-MacLeod syndrome, or foreign body aspiration. V/Q imaging showed markedly diminished right lung ventilation and perfusion, especially in the upper lobe, with a hot spot in the area of the right bronchus. At bronchoscopy, a pistachio nutshell was removed from the right main bronchus.
Departments of Nuclear Medicine, Medical Center Leeuwarden, Leeuwarden, the Netherlands. hans.balink@znb.nl
Hans
H
Balink
James
J
Collins
Astrid G W
AG
Korsten-Meijer
Bart L
BL
Rottier
D002675:Child, Preschool; D005260:Female; D005547:Foreign Bodies / Q000150:complications*; D006801:Humans; D019568:Lung, Hyperlucent / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000503:physiopathology; D011877:Radionuclide Imaging; D014692:Ventilation-Perfusion Ratio