Scoliosis as cause of pulmonary atelectasis

We present a patients with persistent position-dependent productive cough and intermittent fever. He was first examined at 38 yrs of age. Chest X-ray showed a severe thoracic lordoscoliosis and an atelectasis of the right lower lobe. Bronchography revealed a total stenosis of the right lower lobe bronchus. Five years later had increased symptoms. Spirometry showed total lung capacity (TLC) 3.8 l (predicted value 6.7 l), forced vital capacity (FVC) 2.6 l (4.8 l) and forced expiratory volume in one second (FEV1) 1.7 l (3.9 l). Bronchoscopy demonstrated a smooth stenosis of the right lower lobe bronchus but the stenosis could be passed through with a brush. Computed tomographic scanning demonstrated compression of the right lower lobe bronchus and the atelectasis. After surgical removal of the right lower lobe, all symptoms disappeared. Histological examination of the right lower lobe revealed fibrosis and chronic inflammation.