To the Editor: My attention was drawn to the Snapshot of an apical lung hernia published in the Journal last year.1

Persons with emphysematous hypertrophic lungs are often found to have clinically discernible supraclavicular swellings (Box). The finding of these swellings is a surprisingly common sign that is little remarked upon in clinical descriptions.

These swellings are the bullous expansions of the apices of the lungs.

Supraclavicular swelling in patients with emphysematous hypertrophic lungs

A woman (A) and a man (B) with visible supraclavicular swellings.