Horseshoe lung: clinical, pathologic, and radiologic features and a new plain film finding

Frank, JL; Poole, CA; Rosas, George de Queiroz

doi:10.2214/ajr.146.2.217

Cited by 81 publications

(53 citation statements)

References 19 publications

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“…Frank et al described the radiographic signs of horseshoe lung on chest radiographs; these included the presence of a well-defined area similar to an inferior accessory lobe and a fissure medial to the left lung. (9) This fissure corresponds to a pleural line separating the displaced right lung and the adjoining left lung, and is a consistent finding of horseshoe lung on CT. (12) The fused posterobasal segments of the right and left lungs may show imaging features of air trapping, suggesting possible stenosis of anomalous bronchus of the isthmus. (13) The functional importance of excluding a stenosed anomalous bronchus lies in the fact that impaired bronchial clearance results in recurrent pneumonia in the horseshoe lung segment, necessitating pneumonectomy or lobectomy.…”

Section: Discussionsupporting

confidence: 58%

“…(8) Horseshoe lung, a term that was first used by Spencer in 1962, is a rare lung malformation occurring in almost 80% of patients with scimitar syndrome. (9,10) In this rare lung anomaly, the posterobasal segments of both lungs usually show fusion in the midline through an isthmus of normal lung tissue. A parietal pleural defect allows for direct or indirect adherence of lung parenchyma through the intervening visceral pleura.…”

Section: Discussionmentioning

confidence: 99%

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Clinics in diagnostic imaging (173)

Gaikwad

Chawla

Lim

et al. 2017

smedj

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A 56-year-old Chinese man had chest radiography performed as part of a routine work-up for a recent onset of vestibular neuronitis. He presented with severe giddiness and positional vertigo. There was no history of cough, fever or breathlessness. The clinical examination revealed no rales, crepitation or wheezing. There was no previous history of chest infection. The pulse rate, blood pressure and saturation of peripheral oxygen (SpO 2 ) were normal. What do the frontal chest radiograph (Fig. 1) and subsequent non-contrast computed tomography (CT) images of the thorax (Figs. 2a-c) show?

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Section: Discussionsupporting

confidence: 58%

Section: Discussionmentioning

confidence: 99%

Clinics in diagnostic imaging (173)

Gaikwad

Chawla

Lim

et al. 2017

smedj

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show abstract

“…There was no evidence of abnormal arterial supply from the descending aorta to the right lung. Threedimensional computed tomography (CT) scans of the airway revealed horseshoe lung, as previously described by Frank et al 1 (Fig. 1C).…”

Section: Casesupporting

confidence: 58%

Scimitar syndrome in an infant with right lung hypoplasia, ventricular septal defect, and severe pulmonary hypertension

Shinohara

Morita

Uno

et al. 2010

Gen Thorac Cardiovasc Surg

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A 5-month-old boy was presented for surgical repair of scimitar syndrome associated with right lung hyperplasia, severe pulmonary hypertension, ventricular septal defect (VSD), and atrial septal defect. The calculated shunt fraction (Qp/Qs) was 3.1:1.0, pulmonary vascular resistance was 4.6, and the perfusion lung scan showed a marked decrease (11%) in right pulmonary blood flow. Surgical repair was performed through the right fourth intercostal space with the patient supine. The anomalous vein was divided and interposed with a short azygos vein graft, followed by closure of the VSD. Finally, the interposed azygos vein was anastomosed to the left atrium. Although pulmonary artery pressure was normalized at the 2-year follow-up, cardiac catheterization 6 months after the operation demonstrated right pulmonary vein obstruction.

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“…The horseshoe or crossover lung anomaly may occur, as in patient 4, and is another common malformation associated with scimitar syndrome [6,8,9,21]. Airway anomalies, although common, do not seem to be major factors for symptoms.…”

Section: Discussionmentioning

confidence: 97%

Scimitar syndrome: incidence, treatment, and prognosis

Chen

et al. 2007

Eur J Pediatr

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This study is based on a database of 16 years; we sought to define the incidence and outcome of scimitar syndrome. Of 8,771 patients, 5 (0.057%) with scimitar syndrome were identified and constituted the study population. Follow-up ranged from 1 to 16 years (median: 10 years). Diagnosis was assured by computed tomography in four patients and by cardiac catheterization in one. Two patients presented with respiratory distress soon after birth and required early pneumonectomy in one case and coil embolization of the abnormal feeding arteries to the right lower lung followed by surgical rerouting of the abnormal pulmonary vein and repair of the atrial septal defect in the other case. The former was supported by ventilator therapy for 3 years after pneumonectomy, but was finally weaned from the ventilator. Among the other three, two had repeated pneumonia that resolved after rerouting of the abnormal right pulmonary vein and cardiac repair. The asymptomatic child did not receive any intervention. In spite of the abnormal orientation of the airways, none of the four patients with detailed computed tomography imaging showed any significant compression of the airways. All five patients were doing well as of the last follow-up. In conclusion, scimitar syndrome is a very rare disease in this Asian country and the varied symptoms, such as tachypnea and repeated infection, could be improved after interventions.

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Horseshoe lung: clinical, pathologic, and radiologic features and a new plain film finding

Cited by 81 publications

References 19 publications

Clinics in diagnostic imaging (173)

Clinics in diagnostic imaging (173)

Scimitar syndrome in an infant with right lung hypoplasia, ventricular septal defect, and severe pulmonary hypertension

Scimitar syndrome: incidence, treatment, and prognosis

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