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HomePediatrics: General MedicineRight Middle Lobe Syndrome

Right Middle Lobe Syndrome

Background

Right middle lobe syndrome (RMLS) generally refers to chronic or recurrent atelectasis in the right middle lobe of the lung. First described in the medical literature in 1948,
it is caused by various etiologies and has no consistent clinical definition. Right middle lobe syndrome is characterized by a wedge-shaped density that extends anteriorly and inferiorly from the hilum of the lung, which is best visualized using lateral chest radiography.

See the image below.

Lateral view chest radiograph showing a wedge-shap

Lateral view chest radiograph showing a wedge-shaped density extending from the hilum anteriorly and inferiorly.

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This condition is most common in children with a history of asthma or atopy. Although the mechanism by which asthma leads to lobar atelectasis is unknown, associated inflammation, bronchospasm, and secretions that cause mucus plugging are likely major contributors. Management is determined by etiology, and most patients respond to medical therapy alone.

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