Swyer-James症候群の1例

A case of Swyer-James syndrome

　Swyer-James症候群は，1953年にSwyerとJames^1）が一側肺の透過性亢進と肺動脈の狭小化を示した小児例を報告したのにはじまる。その後，unilateral hyperlu—cent lung，unilateral lung transradiancyなどの題名で同様の症例が報告されているが，本邦では富樫ら^2）による報告例が最初である。本症候群を示す症例は，小児期に肺感染症の既往歴をもつものが多く，病因として小児期における肺感染症が考えられる。

　今回著者らは，肺結核が病因と考えられたSwyer—James症候群の1例を経験したので若干の考察を加えて報告する。

55-year old man admitted to our hospital for further examination of abnormal chest roentgenogram. He had been hospitalized for treatment of pulmonary tuber-culosis at the age of nineteen. Chest roentgenogram showed left hyperlucent lung and small left pulmonary artery. Pulmonary perfusion scintigram showed perfusion defect of the left lung and pulmonary arteriogram revealed marked narrowing of the left arterial trees. Left thorax was smaller than right on computerized tomogram. Bronchogram showed no sign of bronchial obstruction. From these findings, he was diagnosed as Swyer-James syndrome.

Infantile pulmonary infections are thought to consti-tute one of the etiologies of Swyer-James syndrome, but our case had no episode of pulmonary infection on childhood. However, it is said that the number of alveoli increases until the age of 8 years, but size increases until growth of the chest wall finishes with adulthood. Our case suggests that Swyer-James syndrome could be caused bv pulmonary infections even after childhood.