CTICasesChest Wall Lipoma and Pulmonary Hamartoma (Complete versus Incomplete Border Sign)
Imaging findings
Chest radiograph demonstrates two right-sided lesions: one with a complete border sign (visible on all edges) localized to the lung parenchyma on lateral view, and a second lesion with an incomplete border sign (obscured medially along the pleura/chest wall). The complete-border lesion proved to be a pulmonary hamartoma; the incomplete-border lesion was a chest wall lipoma.
Key takeaways
The complete border sign on chest radiography indicates a pulmonary parenchymal location, as the lesion is surrounded on all sides by aerated lung. The incomplete border sign, with one margin lost against the chest wall or pleura, indicates an extra-pulmonary (pleural or chest wall) origin. This distinction prevents satisfaction-of-search errors and guides further workup.
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