CTICasesSuperior Accessory Fissure
Imaging findings
A chest radiograph demonstrates lower lobe consolidation with a very sharp, straight superior interface on the frontal projection. A chest CT confirms that the consolidation is bounded superiorly by a superior accessory fissure, which separates the superior segment from the basal segments of the lower lobe.
Key takeaways
Anatomical variants such as accessory fissures can alter the classic lobar distribution of pulmonary processes like pneumonia. A superior accessory fissure is a common congenital variant that can create a sharp, straight horizontal boundary on a frontal chest radiograph, which should not be misinterpreted as a major or minor fissure or a mass.
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