There is widening of the upper mediastinum to both sides with marked deviation
of the trachea to the right.
These findings are typical of a mass in the superior mediastinum, defined as
the portion above the arch of the aorta. The tracheal deviation shows that the
mass must be about half way back between the clavicular heads and the spine.
The vast majority of masses in this location are enlarged lymph nodes or enlarged
thyroid (sometimes called “substernal”). Further evaluation requires Chest CT.
Thyroid adenoma
CORRELATION:
The CT shows a heterogeneous mass in the middle of the mediastinum with the
trachea both narrowed and shifted to the right. The position and lack of nodularity
strongly favor thyroid enlargement over lymph nodes.
