On the middle lobe syndrome

Abstract

Illustrating 12 cases of nontuberculous adults having compression of the middle lobe bronchus by enlarged lymph nodes, Graham, E. et al. first introduced the conception on the middle lobe syndrome into medicine in 1948. Katz, L. H., for the first time, described the relationship between Graham's syndrome and traction diverticula of the oesophagus in 1952, notwithstanding the previous reportors about the oesophageal diverticula. Kunigoshi, U. first here in Japan recognized Katz's fact in 1955. Rosenman, E., on the other hand, reported an article entitled "Acute, Transient Middle Lobe Disease" in 1955.
In the light of Graham's syndrome, Katz's report, Kunigoshi's one and Rosen-man's disease, the conception of the middle lobe syndrome has to be revised and newly defined as follows:
Graham's syndome has to be summarized in Rosenman's disease: that is a group of the diseases which is characterized clinically by hemoptysis and recurrent episodes of pulmonary infection and pathologically by atelectasis, fibrosis, bronchiectasis and/or bronchostenosis after Rosenman's disease has already become irreversible and chronic and which is with peculiar roentgenological appearance easily overlooked, sometimes the formation of oesophageal diverticula and/or displacement and is occasionally made an erroneous diagnosis as neuropathy, cardiopathy or bronchial asthma due to the patients' unexplainable complaints.