A 81 year old male presents with progressive cough and occasional wheeze.
click images to enlarge
Describe and interpret this CXR and CT chest
There is a large soft tissue mass arising from the right superior mediastinum.
The right hilum appears bulky. Both lung fields are over-inflated consistent with COPD.
CT Chest Interpretation:
CT demonstrates a large cystic structure arising from the superior mediastinum with thin walls.
It is partially obstructing the airway due to external compression.
Mediastinal cysts are relatively uncommon.
This will need further work up, however surgery may be indicated.
Causes of mediastinal cysts include bronchogenic, thymic, pericardial, enteric and from teratoma.
While thymic cysts are most common in the anterior mediastinum, others can occur in the middle mediastinum from ectopic remnant thymic tissue