Hampton's Hump Research Articles

Hampton's Hump- A Rare Radiographic Finding in Pulmonary Embolism

Hampton's Hump- A Rare Radiographic Finding in Pulmonary Embolism

CLEARING THE AIR: AN UNEXPECTED CAUSE OF A WEDGE-SHAPED "HAMPTON HUMP" CONSOLIDATION

CLEARING THE AIR: AN UNEXPECTED CAUSE OF A WEDGE-SHAPED "HAMPTON HUMP" CONSOLIDATION

Hamptons hump: An unusual radiological sign of pulmonary embolism

Hamptons hump is a peripheral dome-shaped, opacification abutting the pleura, signifying pulmonary infarction distal to a pulmonary embolism. We report a case of pulmonary embolism that presented with the Hampton’s hump sign on a chest X-ray, which is an unusual yet moderately specific indicator for diagnosing pulmonary embolism.

Jump to the diagnosis from Hampton's hump

Jump to the diagnosis from Hampton's hump

Hampton hump in acute pulmonary embolism.

Hampton hump in acute pulmonary embolism.

A Frequently Missed Pulmonary Infarction: Clinical and 18F-FDG PET/CT Manifestation of Hilar Tumor-Induced Pulmonary Infarction.

PurposeThis study aimed to summarize the clinical and 18F-FDG PET/CT manifestations of hilar tumor–induced pulmonary infarction.MethodsA retrospective analysis was performed on patients with hilar masses who underwent FDG PET/CT scans between July 2015 and January 2021 and had complete clinical data. Pulmonary infarction was confirmed by concurrent chest CT and imaging follow-up or pathology.ResultsA total of 58 patients (mean age, 56 [SD, 13] years; 44 males) with 122 infarcts were included in the study. Hilar masses were mostly associated with small cell lung cancer (64%). The most common clinical manifestations were cough (64%) and hemoptysis (36%). Most patients (62%) had multiple pulmonary infarcts. The CT findings of pulmonary infarcts included the “Hampton hump” (48%) and patchy consolidation (52%). The density of infarcts included “bubbly consolidation” (61%) and “homogenous consolidation” (39%). The metabolic activity of 95 infarcts (78%) was higher than lung parenchyma, with the SUVmax of 3.3 (SD, 1.1). The metabolic patterns on PET/CT were “rim sign,” “mismatch between PET and CT,” and “no metabolism.” Pulmonary vein involvement was found in 25 patients (43%), pleural effusion in 22 patients (38%), and the pleural curvilinear sign in 8 patients (14%).ConclusionsThe clinical manifestations of hilar tumor–induced pulmonary infarction are not specific, and 18F-FDG PET/CT could be an effective diagnostic tool.

HAMPTONS SIGN

Hampton's hump, also called sign, is a radiologic sign which consists of a shallow wedge-shaped opacity in the periphery of the lung with its base against the pleural surface. It is named after Aubrey Otis Hampton, who first described it in 1940. A juxtapleural pulmonary soft tissue density on a chest radiograph, convex toward the hilum, usually at the costophrenic angle; described as a manifestation of pulmonary infarction, due to pulmonary embolism. In most cases, pulmonary embolism is caused by a blood clot in the leg that breaks loose and travels to the lungs. A blood clot in a vein close to the skin is not likely to cause problems. But having blood clots in deep veins (deep vein thrombosis) can lead to pulmonary embolism. More than 300,000 people each year have deep vein thrombosis or a pulmonary embolism. Other things can block an artery, such as tumors, air bubbles, amniotic fluid, or fat that is released into the blood vessels when a bone is broken. But these are rare and uncommon.

Aubrey Hampton and Benjamin Castleman: Hampton's Hump.

In the early 20th century, the field of roentgenology (now referred to as radiology) was still developing an understanding of how to interpret roentgenograms (now referred to as x-rays) of various parts of the body, and in many cases relied on comparing what was seen on a roentgenogram to autopsy findings. Drs. Aubrey Hampton and Benjamin Castleman highlighted these issues in their 1940 article:

Jump to the diagnosis from Hampton's hump.

Jump to the diagnosis from Hampton's hump.

Medical image of the month: Hampton hump and Palla sign

Medical image of the month: Hampton hump and Palla sign

Hampton's Hump and Westermark Sign: An Interesting X-Ray View

Hampton's Hump and Westermark Sign: An Interesting X-Ray View

The chest X ray in pulmonary embolism: Westermark sign, Hampton's Hump and Palla's sign. What's the difference?

Pulmonary embolism (PE), with the incidence of about 60 per 100 000 annually, can be a life- threatening disease if it is not treated promptly. It has been estimated that some 10% of PE patients die within the first hour of the event. Untreated PE has a mortality of about 30%. PE is a condition that is treatable if suspected and diagnosed early. The chest radiograph is still the first investigation that is ordered in patients presenting with cardiorespiratory symptoms or symptoms suggestive of PE. The CXR is also helpful in identifying or excluding other conditions or diagnoses. Thus, knowing and understanding some of the more specific CXR signs can be useful. We suggest that physicians to be aware of and utilize CXR findings such as Palla's sign, Westermark sign and Hamptons hump to help with the diagnosis of PE and to exclude other conditions that can mimic venous thrombo-embolism. Even if these signs are not common, their presence, even in an unsuspected patient without a high pretest probability of PE, should prompt further investigations such as a D-dimer test, lung scintigraphy or computed tomography pulmonary angiography as required.

Hampton's Hump in Pulmonary Embolism

None Available Copyright Information: Copyright 2016 by the article author(s). This work is made available under the terms of the Creative Commons Attribution4.0 license, http://creativecommons.org/licenses/by/4.0/

Hampton's Hump

Hampton's Hump

Hampton's hump in a patient with PDA endocarditis

Hampton's hump in a patient with PDA endocarditis

Clinics in diagnostic imaging (152). Right lower lobe segmental pulmonary embolus.

A 56-year-old man presented to the Accident and Emergency Department with pleuritic chest pain of sudden onset. He gave a history of short-distance air travel ten days earlier. Chest radiograph showed a peripheral-based opacity in the right lower zone, which was not seen in a previous study done three months ago, suggestive of Hampton's hump. The D-dimer level was raised. Computed tomography pulmonary angiography confirmed the diagnosis of pulmonary embolism in a right lower lobe segmental branch, with adjacent collapsed lung, consistent with lung infarction. The patient was started on heparin injection with significant relief of his symptoms. The clinical and imaging features of pulmonary embolism are described, with emphasis on the historical radiographic signs and the current dual-energy computed tomography innovations.

Fever, thoracic pain, skin lesions and Hampton hump

A 56-year-old white woman who had previously been healthy had been admitted to hospital 6 months previously for 2 months due to fever for 1 week associated with an onset...

The Hampton Hump in Acute Pulmonary Embolism

The Hampton Hump in Acute Pulmonary Embolism

Hampton's Hump in a Patient with Severe Left Ventricular Dysfunction and Biventricular Thrombosis

A 56-year-old man presented to the emergency room with a history of cough and hemoptysis for one week. Two months earlier, he had been diagnosed with dilated cardiomyopathy on the basis of clinical and echocardiographic features. He also reported worsening shortness of breath over the last week. He denied chest pain or fever. His blood pressure was 120/90 mm Hg, heart rate was 108 beats/minute, respiratory rate was 22/minute, body temperature was 97°F, and capillary oxygen saturation was 98% on air. Physical examination revealed bilateral crackles at the bases of both lungs. The on-call physician prescribed antibiotics and diuretics pending further investigation. His chest X-ray showed Hampton's hump, a wedge-shaped area of consolidation in the right lower lung field (Fig. 1, arrow), which prompted the suspicion of pulmonary infarction.1) Transthoracic echocardiography showed severe global left ventricular dysfunction and biventricular thrombosis {Fig. 2. LV: left ventricle, RV: right ventricle, thrombi (arrows and asterisks)}. We treated the patient with unfractionated heparin and warfarin. A repeat echocardiogram eight days later indicated that the biventricular thrombi had completely resolved. The patient was discharged when the International Normalized Ratio was 3.2 on oral anticoagulation. Fig. 1 Fig. 2 The diagnosis of pulmonary embolism is particularly challenging in low income settings due to expensive investigations, such as computed tomography, which are not routinely available.2) In this case, the rare finding of biventricular thrombosis on echocardiography together with Hampton's hump on chest X-ray was helpful in establishing the diagnosis of pulmonary embolism and infarction.3)

Life-saving percutaneous intervention in young patient with massive pulmonary embolism

Massive pulmonary embolism (PE) is not an uncommon condition, and it usually carries a high risk of mortality. It is one of the fatal conditions that commonly affect young patients. A definitive treatment for patients with massive PE is still lacking, and surgical intervention carries a substantial mortality risk. Thus, percutaneous intervention (clot fragmentation and/or aspiration) remains an option in some patients, specifically in those with a risk of bleeding, contraindicating the use of thrombolysis. There have been no randomized trials to validate percutaneous intervention in massive PE. A sufficient level of evidence is still lacking, and its use depends upon the expert committee’s opinion and study of previous case reports. We present a 23-year-old man with first onset massive PE secondary to protein C deficiency, who was treated successfully with the combination of systemic thrombolysis and percutaneous interventions.