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Chest

The Golden S Sign – Right Upper Lobe Collapse

History: middle aged female with cough. 

Right upper lobe collapse - Frontal radiograph of the chest reveals a classic Golden S sign (yellow arrow), compatible with complete collapse of the right upper lobe.

Right upper lobe collapse – Frontal radiograph of the chest reveals a classic Golden S sign (yellow arrow), compatible with complete collapse of the right upper lobe.

Right Upper Lobe Collapse - Lateral chest radiograph reveals complete collapse of the right upper lobe with opacity anterior to the right major fissure (yellow arrow).

Right Upper Lobe Collapse – Lateral chest radiograph reveals complete collapse of the right upper lobe with opacity anterior to the right major fissure (yellow arrow).

Right Upper Lobe Collapse - Coronal CT of the chest with intravenous contrast reveals complete collapse of the right upper lobe with elevation of the minor fissure (yellow arrow), indicating a Golden S sign on CT.

Right Upper Lobe Collapse – Coronal CT of the chest with intravenous contrast reveals complete collapse of the right upper lobe with elevation of the minor fissure (yellow arrow), indicating a Golden S sign on CT.

This is a nice example of right upper lobe collapse and the classic Golden S sign, which is the elevated minor fissure convex inferiorly on the proximal/medial portion and concave inferiorly on the distal or lateral portion. This sign is classically seen with post-obstructive atelectasis due to a central hilar mass, which this patient had (not shown).

Case courtesy of Andrew Yen M.D.

See another case of atelectasis here.

References:

Gupta, P. The Golden S Sign. Radiology 2004; 233:790–791.

Check out my e-book, Radiology Cases, on the Amazon Kindle Store.

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Check out my e-book, Radiology Cases, on the Amazon Kindle Store.

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About radiologypics

I am a radiology physician from California, USA.

Discussion

6 thoughts on “The Golden S Sign – Right Upper Lobe Collapse

  1. The left marker is backwards which suggests this radiograph is flipped does it not? Did she also have situs inversus? I am confused

    Posted by Susan P | October 10, 2014, 6:43 am

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