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Small cell lung cancer

Case contributed by: Dr Frank Gaillard

Presentation:

Elderly male patient presenting with weight loss.

Modality: X-ray

Case Discussion:

CXR demonstrates a large opacity in the right upper zone consistent with collapse of the right upper lobe secondary to a hilar mass. Note the hyperlucency of the hyperexpanded right lower and middle lobe, and elevation of the right hemidiaphragm, either due to volume loss or less likely phrenic nerve paralysis

Although not particularly S shaped, the collapse of the right upper lobe and a hilar mass are the components of the Golden's S sign

This patient went on to have cross sectional imaging (not shown) and a biopsy which confirmed small cell lung cancer

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