Hilum overlay sign

Case contributed by Ian Bickle
Diagnosis certain

Presentation

Cardiology patient. Cough and weight loss.

Patient Data

Age: 70
Gender: Female
x-ray

Dual lead pacemaker.

4cm mass projected over the right hilum.  The hilar vasculature is separately identified.

Spine unremarkable.

Case Discussion

An excellent example of the hilum overlay sign - the mass lies in a plane other than that of the hilar vessels, which are visualized 'through' the mass.

This was a primary lung cancer on subsequent imaging.

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