To the Editor.—I read with interest the article by Williams et al regarding pulmonary resections in children (Archives 112:481-483, 1977). I noted that one of their infants had the Swyer-James syndrome and that in the discussion following the article, Dr Williams commented that this syndrome is "the situation of a unilateral hyperlucent lung syndrome in association with congenital absence of the pulmonary artery." In fact, congenital absence of the pulmonary artery is one of the differential diagnoses in the unilateral hyperlucent lung syndrome in children but is not the underlying basis for this particular syndrome. This syndrome was initially described by Swyer and James1 who documented the case history of a 6-year-old boy with recurrent lower respiratory tract infection and a hypovascular lung. Other synonyms applied to this disorder include Macleod's syndrome, unilateral emphysema, unilateral lung transradiency, and unilateral hyperlucent lung.
This syndrome usually has its origins in