The Golden S sign was first described in 1925 by Golden Ross as occurring when there is a proximal mass causing collapse of the right upper lobe of the lung. This causes the minor fissure to take on an S or reverse S shape that is convex centrally but concave peripherally. The presence of the Golden S sign should raise suspicion for primary bronchial carcinoma in an adult patient, though other causes can include primary mediastinal tumors, metastases, or enlarged lymph nodes. While the sign cannot definitively diagnose bronchogenic carcinoma, it alerts radiologists to consider this possibility.

1. GOLDEN S SIGN
BY- DR BHAVANA K

2. 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.

3. What is this sign?
Also called as Reverse S of Golden.

4. 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 .

5. It can be seen in
other lobes as well.

6. 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.

7. 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.

8. THANK YOU