Right upper lobe atelectasis due to endobronchial mass

Case contributed by Stefan Tigges
Diagnosis almost certain

Presentation

Shortness of breath and cough.

Patient Data

Age: 80 years
Gender: Female

Right upper lobe atelectasis and probable S-sign of Golden, indicating the presence of a right hilar mass.

Mass within the right main bronchus occluding the right upper lobe bronchus, resulting in right upper lobe atelectasis. Because of the lack of intravenous contrast, it is difficult to tell how much of the soft tissue around the right bronchus is atelectatic lung and how much is mass.

Case Discussion

The chest X-ray shows typical findings of right upper lobe atelectasis, with upward and medial displacement of the horizontal (minor) fissure and displacement of the trachea toward the atelectatic lung. CT confirms atelectasis and shows the endobronchial lesion which most likely represents lung cancer. Intravenous contrast may have been helpful in differentiating atelectatic lung and hilar mass, but was not given in this case.

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