Abstract
Unilateral hypertransparent hemithorax requires a particular diagnostic approach as it can be the result of diverse pulmonary diseases, including pneumothorax, large pulmonary embolus, unilateral large bullae, mucous plag, airway obstruction and contralateral pleural effusion. Congenital syndromes with chest wall abnormalities, are rare, but often underdiagnosed causes. Poland Syndrome consists of such a rare, congenital anomaly and is characterized by the absence of the pectoralis major muscle and upper limb ipsilateral abnormalities. We present a case of a patient with acute exacerbation of chronic obstructive pulmonary disease (COPD) and a unilateral hypertransparency on chest radiology, attributed to the underlying Poland Syndrome.
Highlights
Unilateral hypertransparent hemithorax requires a particular diagnostic approach as it can be the result of diverse pulmonary diseases, including pneumothorax, large pulmonary embolus, unilateral large bullae, mucous plag, airway obstruction and contralateral pleural effusion
Chest computed tomography confirmed the asymmetry of the chest with absence of the pectoralis muscles and costal cartilage of ribs 3 through 5 on the right hemithorax (Figs 2−4), suggesting the diagnosis of Poland Syndrome, a rare congenital malformation
Its incidence is estimated between 1:35,000 and 1:50,000 [1]. It consists of a rare, congenital anomaly associated with absence of the pectoralis major muscle [1] and upper limb ipsilateral abnormalities such as syndactyly [2, 3]
Summary
Unilateral hypertransparent hemithorax requires a particular diagnostic approach as it can be the result of diverse pulmonary diseases, including pneumothorax, large pulmonary embolus, unilateral large bullae, mucous plag, airway obstruction and contralateral pleural effusion. A 65-year old male, current smoker (60 pack-years) with medical history significant for chronic obstructive pulmonary disease (COPD) was admitted to our department complaining of shortness of breath, cough and increased purulent sputum production. Physical examination revealed wheezing and prolonged forced expiratory time, proposing the diagnosis of acute exacerbation of COPD.
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