CTICasesFleischner Sign of Acute Pulmonary Embolism
Imaging findings
A chest radiograph obtained when a patient presented with chest pain shows the interlobar pulmonary artery appearing fuller and denser, almost mass-like, compared with an older baseline image. CT angiography confirmed large clots.
Key takeaways
An enlarged, prominent interlobar pulmonary artery (the Fleischner sign) can be a real, if not particularly sensitive or specific, radiographic sign of acute pulmonary embolism. The enlarged side is generally where the non-occlusive acute embolus lies, with associated vasodilation, whereas the Westermark sign of oligemia is thought to be more a feature of chronic embolism with vasoconstriction.
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