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William A. Golden, MD; James Myers, MD

JAMA. 1979;242(10):1079-1080.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

History

An asymptomatic 52-year-old man was found to have an abnormal chest roentgenogram on a routine evaluation.

Diagnosis

Congenital absence of the left pectoral muscle.

Figure 1 shows unilateral hyperlucency of the left lung field. The clue to the diagnosis was the discrepancy in extrathoracic soft-tissue shadows. Physical examination disclosed that the patient had congenital absence of the left pectoralis major, left nipple, and left chest wall hair (Fig 2). The unilateral deficiency in muscle mass had caused the diminished density on the chest film.

This anomaly is a form of Poland's¹ syndrome, an embryologic defect of the mesoderm first recognized in 1841 and recently reviewed.^2,3 Patients with Poland's syndrome have a variable incidence of syndactyly, brachydactylia, hypoplasia of some of the elements of the corresponding upper extremity, thoracic cage defect, absent nipple, and axillary web.

When presented with a roentgenogram of a unilateral hyperlucent lung, one must . . . [Full Text PDF of this Article]

Author Affiliations
From the Department of Medicine, Veterans Administration Hospital, and the Division of Biology and Medicine, Brown University, Providence, RI.

Footnotes
Reprint requests to Pulmonary Division, Rhode Island Hospital, 593 Eddy St, Providence, RI 02902 (Dr Golden).

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