GOLDEN S SIGN

BY- DR BHAVANA K

When was it first described?

It was first described by Golden Ross. In an article called “Effect of bronchostenosis

upon the roentgen ray shadow in carcinoma bronchus” 1925 AJR.

What is this sign?

Also called as Reverse S of Golden.

Why does this sign occur? First described in right upper lobe collapse usually due to a proximal mass.

The minor fissure is displaced superiorly and is concave peripherally but convex centrally, and the shape of the fissure resembles an S or a reverse S .

It can be seen in other lobes as well.

What does the sign signify?PRIMARY BRONCHIAL CARCINOMA should be suspected in any adult patient with golden S sign.Other causes: • Primary mediastinal tumour.• Metastasis• Enlarged lymph nodes The sign may be useful for distinguishing a central obstructing mass from a consolidative process such as bacterial pneumonia.

Bronchogenic carcinoma cannot be diagnosed definitively on the basis of this radiographic sign, but the Golden S sign should alert the radiologist to consider this sinister diagnosis.

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