A case of unilateral hyperlucent lung associated with aortic valve disease
Aida, H.; Yamaguchi, S.; Iwanami, H.; Nakajima, M.; Sakamoto, S.; Yoshimatsu, M.; Anzai, Y.; Watanabe, K.; Ohya, N.
Nihon Kyobu Geka Gakkai 29(8): 1373-1380
1981
ISSN/ISBN: 0369-4739 PMID: 7299223 Document Number: 174584
A 31-yr-old female with a previous history of several respiratory infections during infancy was studied. Over the left lung area, respiratory sound was inaudible. Only moist rales were heard. Heart murmurs were typical of aortic valve stenosis and insufficiency. The chest roentgenogram revealed the increased translucency of the left lung field. Bronchography showed a peculiar appearance on the left side because the peripheral bronchi failed to fill, with a sharp line of demarcation between the proximal filled and the peripheral unfilled parts. Angiocardiography showed a small caliber of left pulmonary artery and confirmed the poor vascular filling of the left lung compared with the normal right pulmonary artery. This patient was diagnosed as having unilateral hyperlucent lung (UHL) with aortic valve disease, and aortic valve replacement was successfully carried out. Surgical treatment for the affected left lung was not performed because of no signs of infection. Only a lung biopsy was done. The origin of aortic valve disease was suspected rheumatic. The pathological findings of left lung showed chronic bronchiolitis with focal fibrous alveolitis and mild emphysema. Although respiratory function decreased, lung perfusion scan and ventilation scan showed almost no shunt effect on the affected left lung. In post-operative course was uneventful. In case of developing respiratory dysfunction, the left pneumonectomy should be considered. UHL has seemed to be a very rare disease and only a few cases were previously reported in Japan. Association of the heart disease with UHL may be the 1st in Japan.