Kirklin sign

Excerpt

Alteration in contour or soft tissue mass lesion in the gastric fundal air shadow on an erect chest radiograph is known as Kirklin sign (Fig. 1) [1]. This sign is named after Dr. B.R. Kirklin, a radiologist who wrote an article on the radiologic features of cancer of the cardia in 1939 [2]. The deformity is usually on the medial aspect but may also be seen on the superior as well as lateral aspect of the fundus. The sign was based on the premise that the air-filled fundus of the stomach is normally so regular in outline and translucent that cancers in cardia or fundus region invariably produce visible soft tissue shadows or contour deformities [2]. Although classically described as a sign of malignant lesions of the cardia or fundus, it has also been described in association with stromal cell tumors, lymphomas, gastric varices, and the following procedures such as fundoplication and splenectomy [1, 3]. In spite of the low probability of detecting an occult gastric carcinoma on a chest radiograph, it is important to be aware of the importance of analyzing the gastric bubble for intraluminal deformities.

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