Presentation
Cough. H/o breast tumor.
Patient Data
Chest radiograph demonstrates the Golden S sign. It is also referred to as the ''reverse S sign of Golden''.
Case Discussion
Frontal chest X-ray shows increased attenuation due to a right upper lobe collapse, and this is bordered by the elevated minor fissure which is concave inferiorly forming the superior part of the reversed S. The hilum is elevated and convex, forming the inferior part of the "S", and this is due to a hilar mass.
The Golden S sign can be seen on both the chest radiograph and the CT scan. It should alert team to the likely cancer diagnosis.
Differential diagnoses include metastasis, lymphoma, primary mediastinal tumor and voluminous lymph nodes.