Golden S-sign (lung)

Last revised by Mohammad Taghi Niknejad on 16 Aug 2024

The Golden S-sign is seen on both chest radiographs and CT scans. It is named because it resembles a reverse S shape and is sometimes called the reverse S-sign of Golden.

Although typically seen with right upper lobe collapse, the S-sign can also be seen with the collapse of other lobes. It is created by a central mass obstructing the upper lobe bronchus and should raise suspicion of a primary bronchogenic carcinoma. Other central masses, such as metastasis, primary mediastinal tumor, or enlarged lymph nodes, can also cause it.

The Golden S-sign is seen on frontal chest radiographs. In the most common situation, the appearance is that of right upper lobar collapse (the right upper lobe appearing dense and shifting medially and upwards) with a central mass expanding the hilum. Together, these two changes form a reverse S-shape.

The sign was first described by Ross Golden (1889-1975), American radiologist, in 1925 3.

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