Small-cell lung cancer - right upper lobe collapse
Substantial unintentional weight loss
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CXR demonstrates a large opacity in the right upper zone consistent with collapse of the right upper lobe secondary to a hilar mass. Note the hyperlucency of the hyperexpanded right lower and middle lobe, and elevation of the right hemidiaphragm, either due to volume loss or less likely phrenic nerve paralysis.
Although not particularly S shaped, the collapse of the right upper lobe and a hilar mass are the components of Golden's S sign.
This patient went on to have cross sectional imaging (not shown) and a biopsy which confirmed small cell lung cancer.