25 y/o former smoker with atypical chest pain and shortness of breath for 2 months.
â€˘ On PA/Lat chest radiograph an abnormal contour overlying the upper mediastinum is seen which projects anteriorly on the lateral view. An additional finding of mass effect causing posterior displacement of the trachea is concerning for a large anterior mediastinal mass. Contrast enhanced chest
â€˘ CT demonstrates a large heterogeneous mass in the superior anterior mediastinum causing deviation of the trachea to the right. The proximal portion of the major branches from the aortic arch are slightly narrowed due to this mass, especially at the left common carotid artery. An enlarged lymph node is seen in the right hilum as well as two pulmonary nodules in the right upper lobe.
â€˘ Thymoma or other thymic lesions
â€˘ â€śTerribleâ€ť Lymphoma (most commonly Thomas Hodgkinâ€™s and NHL)
â€˘ Teratoma and other germ cell tumors (seminoma, choriocarcinoma)
â€˘ Thyroid lesions
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