Pediatric Radiology

, Volume 40, Issue 3, pp 375–375 | Cite as

Thymic sail sign: unique to paediatric chest radiographs?

  • Dae Hee HanEmail author
Letter to the Editor


Public Health Soft Tissue Young Adult Nuclear Medicine Chest Radiograph 
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I read with great interest the article by Enriquez et al. [1], entitled “Pitfalls in chest imaging.” In their article, the authors elaborated on potential pitfalls of radiography, CT, and US that radiologists may encounter in their daily practice.

According to their article, the thymus cannot be visualized after the age of 8 years. In my practice, however, I occasionally observe the sail sign on the posterior-anterior (PA) chest radiographs of adults (Fig. 1). Mostly, it represents fat tissue extending from the anterior mediastinum [2]. However, such fat tissue may contain thymic soft tissue as seen in the remainder of the anterior mediastinal fat, and I have observed this phenomenon in a 42-year-old man (Fig. 2). Even more thymic tissue will be present in such a sail-like shadow of a younger adult, and it may not be entirely true that the thymus is not radiographically visible in individuals older than 8 years.
Fig. 1

PA chest radiograph of a 55-year-old man shows a triangular shadow in the right hilum with an upper margin concave to the lung (arrows)

Fig. 2

Thin-section CT of a 42-year-old man showing wisps of soft tissue within a sail-like shadow (arrow), which are identical to those within the anterior mediastinal fat


  1. 1.
    Enriquez G, Garcia-Peña P, Lucaya J (2009) Pitfalls in chest imaging. Pediatr Radiol 39(Suppl 3):356–368CrossRefPubMedGoogle Scholar
  2. 2.
    Lee YJ, Han D, Koh YH et al (2008) Adult sail sign: radiographic and computed tomographic features. Acta Radiol 49:37–40CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  1. 1.Department of Radiology, Seoul St. Mary’s HospitalThe Catholic University of KoreaSeoulRepublic of Korea

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