Linear atelectasis may occur as a consequence of obstruction in the bronchus of a pulmonary subsegment. It is normally horizontal and sometimes oblique or perpendicular. Linear atelectasis is a focal area of subsegmental atelectasis with a linear shape. In this patient subgroup, who are otherwise asymptomatic, a persistent linear atelectasis can be due to primary lung cancer. Thick perihilar linear atelectasis is a new diagnostic roentgen sign that suggests subsegmental bronchial obstruction. A statistically significant relationship ( P 5.5 mm) perihilar linear atelectasis found to have primary lung cancer. Atelectasis was caused by an obstructing tumor in 21 (36%) cases and a variety of other conditions in 37 (64%) patients. Perihilar linear atelectasis was demonstrated in 58 patients. Student's t-test was used to evaluate statistical significance, correlating the thickness of atelectasis and the presence of obstructing central primary lung cancer. When linear atelectasis was found, the total thickness was measured. The perihilar region of chest radiographs was evaluated for the presence of linear atelectasis. We performed a retrospective review of 45,000 posteroanterior chest radiographs to determine the frequency of appearance and characteristics of perihilar linear atelectasis. We propose an early roentgen sign of obstructing lung tumors, namely perihilar linear atelectasis, and ascertain whether this phenomenon could be used as a sign to detect radiographically occult primary lung cancer. Linear atelectasis may occur as a consequence of subsegmental bronchial obstruction.
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