Pneumonia with hilum overlay sign

Case contributed by Ibrahim Alsheikh Deeb
Diagnosis certain

Presentation

Cough and fever

Patient Data

Age: 19 years
Gender: Male

Chest

x-ray
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Info

There is an opacity projecting in the right hilar/perihilar region with preserved hilar contour, indicating that the abnormality is not arising from the hilum. It can be located either anterior or posterior to the hilum.

Few nodular opacities are seen lateral to the forementioned opacity.

CT chest on same day

ct
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This study is a stack
Axial lung
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This study is a stack
Axial
C+ CTPA
This study is a stack
Coronal
C+ CTPA
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Contrast-enhanced CT scan of the chest performed on the same day shows consolidation in the anteromedial aspect of the right upper lobe with surrounding patchy air space disease, consistent with pneumonia.

Follow up CT scan

ct
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This study is a stack
Axial lung
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Follow up CT scan after treatment showed resolution of pneumonia.

Case Discussion

Hilum overlay sign is the ability to see the normal hilar outline through opacities projecting over the hilum, excluding pathologies being of hilar origin or involving the hilum.

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