Presentation
Right-sided chest pain, dyspnea and hemoptysis. Lifelong heavy smoker.
Patient Data
Age: 65 years
Gender: Male
From the case:
Golden S sign with rib and clavicle metastases
{"current_user":null,"step_through_annotations":true,"access":{"can_edit":false,"can_download":true,"can_toggle_annotations":true,"can_feature":false,"can_examine_pipeline_reports":false,"can_pin":false},"extraPropsURL":"/studies/85121/annotated_viewer_json?iframe=true\u0026lang=us"}
Right upper zone opacification contiguous with a right hilar mass. Loss of the right mediastinal contour. The horizontal fissure is retracted superiorly. Elevation of the right hemidiaphragm and rightward mediastinal shift.
Distal right clavicle and right 10th rib lytic lesions. Right lateral 5th rib subtle expansion suspicious of a lesion.
Case Discussion
This case is a classic example of the Golden S sign, indicating RUL collapse secondary to an obstructing right hilar mass.
Staging CT confirmed a large right hilar mass, collapse of the right upper lobe and several osseous metastases. Biopsy confirmed NSCLC.