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Citation:
Gaillard F, Anterior upper lobe sign (usual interstitial pneumonia). Reference article, Radiopaedia.org (Accessed on 20 Jan 2025) https://doi.org/10.53347/rID-179616
The anterior upper lobe sign is an HRCT finding usually seen in the setting of usual interstitial pneumonia. It represents fibrosis primarily in the anterior aspect of both upper lobes, sparing the rest of the upper lobes while coexisting with concurrent involvement of the lung bases 1-3.
In the context of usual interstitial pneumonia, the presence of the anterior upper lobe sign, along with the exuberant honeycombing sign and the straight-edge sign, has a fairly high specificity but moderate sensitivity for being the result of connective tissue disease-associated interstitial lung disease (CTD-ILD) rather than idiopathic pulmonary fibrosis (IPF) 1,3.
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1. Brady D, Berkowitz E, Sharma A et al. CT Morphologic Characteristics and Variant Patterns of Interstitial Pulmonary Fibrosis in Systemic Lupus Erythematosus. Radiology: Cardiothoracic Imaging. 2021;3(4):e200625. doi:10.1148/ryct.2021200625 - Pubmed
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2. Mohning M, Richards J, Huie T. Idiopathic Pulmonary Fibrosis: The Radiologist’s Role in Making the Diagnosis. BJR. 2019;92(1099):20181003. doi:10.1259/bjr.20181003 - Pubmed
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3. Chung J, Cox C, Montner S et al. CT Features of the Usual Interstitial Pneumonia Pattern: Differentiating Connective Tissue Disease–Associated Interstitial Lung Disease From Idiopathic Pulmonary Fibrosis. AJR Am J Roentgenol. 2018;210(2):307-13. doi:10.2214/ajr.17.18384 - Pubmed
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