Matched ventilation-perfusion becomes mismatched ventilation-perfusion lung imaging after resolution of carcinoma of the bronchus.

Airway occlusion results in regional alveolar hypoxia followed by reflex hypoxic pulmonary arterial constriction. Ventilation-perfusion imaging demonstrates matched defects. In the two patients reported, occlusion of the main bronchus by bronchogenic carcinoma was resolved--in one case by radiation therapy, and in the other by removal of the tumor mass in the bronchus by bronchial slitted biopsy. The initially matched ventilation-perfusion findings became mismatched. While ventilation was presumed to be normal, pulmonary perfusion was not completely reversed.