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Fleischner sign with pulmonary hypertension complicated by thrombosis

Hashrul NZ Rashid and Kenneth KP Lau
Med J Aust 2016; 205 (6): 252. || doi: 10.5694/mja16.00410
Published online: 19 September 2016

A 73-year-old woman with chronic obstructive pulmonary disease presented with 4 weeks of exertional dyspnoea. A plain chest x-ray revealed a right hilar enlargement with enlarged pulmonary outflow tract (Fleischner sign; Figure, A [arrow]) and mild cardiomegaly. A computed tomography pulmonary angiogram confirmed the presence of marked dilatation of the pulmonary trunk (Figure, B [arrow]) and arteries with a large mural thrombus (Figure, B [star]). An echocardiogram indicated pulmonary hypertension with an elevated pulmonary artery pressure of 88 mmHg.

  • Hashrul NZ Rashid
  • Kenneth KP Lau

  • Monash Health, Melbourne, VIC


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