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Golden S sign

ChestRadiograph / CT

The elevated fissure of a collapsing lobe forms a reverse-S contour because of a bulging central mass, most classically with right upper lobe collapse.

What it means

Lobar collapse caused by a central obstructing mass, raising concern for bronchogenic carcinoma.

Mechanism

The peripheral fissure is drawn up by collapse while the central portion is pushed down by the hilar mass, creating the S-shaped border.

Associated conditions

  • Central bronchogenic carcinoma
  • Right upper lobe collapse
  • Hilar lymphadenopathy
  • Endobronchial obstruction

Pearls

  • Also called the Golden S sign or reverse-S sign of Golden.
  • The convex central bulge should prompt a search for an obstructing tumour.

References

  • Radiopaedia: Golden S sign

For educational use only. This dictionary is a study aid and reference, not a diagnostic tool, and must not be used to guide clinical decisions or patient care. Imaging appearances vary; always correlate with the full clinical picture and confirm with a qualified radiologist.