Presentation
Chest pain and shortness of breath. Chronic attender.
Patient Data
Cardiomegaly. Prominent pericardial fat pads.
Both pulmonary arteries are enlarged, especially on the right, with the impression of a hilar mass.
Lungs clear.
Case Discussion
The Fleischner sign is a prominent central artery that can be caused either by pulmonary hypertension or by distension of the vessel by a large pulmonary embolus.
In this case it is most evident on the right, although the left is also larger than normal. This was due to pulmonary hypertension.
This case was investigated for what was misinterpreted as a right hilar mass - CT showed this to be merely and enlarged right pulmonary artery.