Shifting granuloma sign

Case contributed by Dr David McComiskey


58 year old female with history of lung cancer presents with weakness.

Patient Data

Age: 58
Gender: Female

There is right upper lobe collapse with shifting of the previously characterised right lower lobe mass superiorly, increased volume loss compared to prior examination (see below), and associated generalised increased density of the right hemisphere. This shifted mass and the nodule in the left upper lobe demonstrate interval increase in size compared to previous. There may be airspace disease or a third lesion in the left lower lobe adjacent to the cardiac silhouette.


Four months earlier

Right hilar enlargement with multiple rounded pulmonary densities. 

Case Discussion

The shifting granuloma sign refers to a shift in the location of a parenchymal lesion visible on prior films seen in the presence of atelectasis. In this case, right upper lobe collapse has shifted the previously characterised right lower lung mass superiorly with associated increased density of the right hemithorax.

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Case information

rID: 48405
Published: 10th Oct 2016
Last edited: 10th Oct 2016
System: Chest
Inclusion in quiz mode: Included

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