35, pCO2: 45 mmHg, PO2: 45 mmHg, HCO3: 24.8. On thoracic computerized tomography (CT) and high resolution CT, right pulmonary artery hypoplasia, reduction in the diameter of the right pulmonary artery branches, hyperlucency, right lung lower lobe bronchiectasis and atelectasis were detected (Figure 2). Since the patient had pulmonary arterial hypertension, the right atrium

was catheterized and she underwent simultaneous coronary angiography due to ECG changes. Pulmonary artery pressures were: systolic 61 mmHg, diastolic 22 mmHg, and mean: 38 mmHg, measured by the invasive catheter. Pulmonary angiographic study of the thorax displayed prominent reduction of caliber in the right pulmonary artery branches (Figure 3). The simultaneously performed coronary angiography revealed normal location and branches of the right coronary artery, Dactolisib research buy while the left coronary system (left anterior descending and left circumflex arteries) was observed to have originated from the right sinus Valsalva as a single coronary artery (Figure 4). Diagnosed as Swyer–James (Macleod) syndrome, antibiotics, bronchodilators and pulmonary hypertension treatment were begun directed toward her complaints. Cataract surgery was recommended directed

to reduced vision. Following the treatment, her symptoms PCI-32765 molecular weight recovered and she was discharged with the recommendations of receiving the viral influenza vaccination every year and pneumococcal vaccination every five years and to come back for follow-up examinations. Although rarely seen, this syndrome was detected at a rate of 0.01% on 17,450 chest X-rays.1, 2, 3, 4, 5 and 6 Our case is the only case of Swyer–James (Macleod) syndrome diagnosed in our clinic in the last two years. Our case is diagnosed at an adult age. Exertional dyspnea, hemoptysis and chronic productive cough are the most prominent symptoms.3 The complaints of cough and sputum recurred since childhood age in our case, and in the last month, chest pain and leg swelling were observed. The patient had been under follow-up treatment for COPD for

up to 7 or 8 years before and for COPD-cor pulmonale in the last 2 or 3 years. The symptoms, history and radiological findings of our PJ34 HCl case were consistent with that of the literature. The main point to be emphasized is that the case was followed-up and managed for up to the age of 60 for chronic bronchitis depending only on her symptoms and neglecting the right hyperlucent lung appearance, and in the last 6 or 7 years, followed-up and treated for COPD-cor pulmonale since the diagnosis of Swyer–James (Macleod) syndrome may be made by routine radiographic investigation. In order to rule out malignancy, a computerized tomography was performed. Computerized tomography findings revealed no mass or findings that would make us think about pulmonary embolism. The presence of a small ipsilateral hilus renders it to be differentiated from pulmonary artery agenesis. The primary pathology is diffuse obstruction in the peripheral airways.