CTICasesMucoepidermoid Tumor of the Right Mainstem Bronchus
Imaging findings
In a 25-year-old patient presenting with hemoptysis, chest radiograph shows medial right lung and mediastinal opacity with associated volume loss, a displaced minor fissure producing a compressed reverse-S sign of Golden, and an obscured right upper lobe bronchus and bronchus intermedius on the lateral view. CT confirms a calcified endobronchial mass extending into the right mainstem bronchus and obstructing the right upper lobe bronchus.
Key takeaways
Although the location and calcification initially suggested carcinoid, resection revealed a low-grade mucoepidermoid tumor, a minor salivary gland-type neoplasm more typically encountered in the trachea than in a mainstem bronchus; the reverse-S sign of Golden and obscuration of expected airway landmarks are reliable radiographic clues to an obstructing central airway lesion even in a young patient, and the low-grade tumor carried a favorable prognosis after bronchial sleeve resection and reconstruction.
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