Fleischner sign

Fleischner sign is a radiological sign named after Felix George Fleischner, an Austrian-American radiologist who made significant contributions to the field of chest radiology. The sign is indicative of a specific pulmonary condition and is primarily observed in chest radiographs or computed tomography (CT) scans of the lungs. It is characterized by the enlargement of the pulmonary artery in one of the lung segments, most commonly associated with conditions such as pulmonary embolism and pulmonary hypertension.

Definition

The Fleischner sign is defined as the enlargement of the right descending pulmonary artery to a diameter of more than 16 mm on a chest radiograph or CT scan. This enlargement is considered a direct sign of pulmonary hypertension and can also be an indirect indicator of other underlying pulmonary conditions.

Clinical Significance

The presence of the Fleischner sign is a critical diagnostic clue in the evaluation of patients with suspected pulmonary embolism or pulmonary hypertension. Pulmonary embolism, a blockage of the pulmonary arteries by a blood clot, can lead to increased pressure in the pulmonary circulation, manifesting as the Fleischner sign. Similarly, pulmonary hypertension, characterized by increased blood pressure within the pulmonary arteries, can also present with this sign.

Diagnosis

The diagnosis of conditions associated with the Fleischner sign involves a combination of clinical evaluation, imaging studies, and sometimes, invasive procedures. Imaging studies, particularly chest radiographs and CT scans, play a pivotal role in identifying the Fleischner sign. In some cases, echocardiography and right heart catheterization may be necessary to assess the severity of pulmonary hypertension and to confirm the diagnosis.

Treatment

Treatment of conditions presenting with the Fleischner sign depends on the underlying cause. For pulmonary embolism, anticoagulant therapy is the mainstay of treatment to prevent further clot formation. In cases of pulmonary hypertension, treatment may include a combination of lifestyle modifications, medications to lower blood pressure in the pulmonary arteries, and in severe cases, surgical intervention.

Prognosis

The prognosis for patients presenting with the Fleischner sign varies depending on the underlying condition and its severity. Early diagnosis and appropriate management are crucial for improving outcomes. Regular follow-up and monitoring are essential for patients with chronic conditions such as pulmonary hypertension.

See Also

• Pulmonary artery
• Pulmonary embolism
• Pulmonary hypertension
• Radiology
• Computed tomography (CT) scan