Caceres’ Corner Case 133 (Update: Solution)


Dear Friends,

Considering that this is Holy Week, I want you to do penance. This week’s images belong to a 73-year-old woman with mild dyspnoea and vague chest complaints.

What do you see? Check the images below, leave your thoughts in the comments section and come back on Friday for the answer.

PA chest

lateral chest

Click here for the answer to case #133

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    Mar 2016
    DISCUSSION 16 Comments

    16 Responses to : Caceres’ Corner Case 133 (Update: Solution)

    1. Olena says:

      There is increased width of mediastinum shadow well defined on frontal and lateral view, suggesting additional mass.

      Probable tymoma

      • Olena says:

        On lateral view – there are:

        -trachea ventral disposition – it seems like this mass is also in posterior part of mediastinum
        -regarding the old age it could be also goiter – because of mass effect on airways
        -compression fracture of the thoracic vertebrae, probable osteoporosis cause

        So, there is additional mass in mediastinum, with positive mass effect on airways, old age

        It could be thymoma, but more it looks like goiter

    2. Dmitriy says:

      Intrathoracic goiter, compression fracture of the thoracic vertebrae

    3. Borsuk says:

      there is oppacification of anterior retrosternal space which correspond to well delineated mass in upper mediastinum on ap view.
      I consider 4T in DDx of anterior mediastinum or vascualar origin of change.

    4. Yunia says:

      Hola Dr.
      En mi valoración de la radiografía veo un ensanchamiento del mediastino, con desplazamiento ventral de la traquea. Me impresiona sea de causa vascular. ¿Tendrá un aneurisma de la aorta ascendente?
      Yunia (la cubana, residente de familia, 🙂 )

    5. genchi bari italia says:

      …pregiatissimo professore , a me, la massa sembra nel mediastino medio, per la compressione e dislocazione in avanti della colonna d’aria tracheale e la dislocazione posteriore dell’esofago…pertanto la massa potrebbe essere di natura adenopatica ( Castleman?).. .ho sbagliato tante volte quest’anno e probabilmente anche questa volta: la mia ” penitenza” la farò a SIVIGLIA, partecipando alle processioni della settimana santa…..Buona Pasqua ed un abbraccio dall'” ANDALUSIA “!

      • Jose Caceres says:

        A believe la Semana Santa en Sevilla is an unique event. Enjoy your time in my city!

    6. Aleksandar says:

      Widened mediastinum with increased retrocardial opacity funneling towards diaphragm. Lateral shows opacity in anterior mediastinum.Tracheal column is shifted to the right and anteriorly. There is pleural effusion of posterior phrenicocostal sinus on the right., better seen on profile.Aneurysm of ascending aorta, aortic arch and descending aorta would be my first guess. There is also reduced vertical diameter of ThV with hyperkyphosis and reduced mineralization of bones.

    7. Bujar says:

      Entire mediastinal widening with double cardiac density. Excluding this pacient anamnestic simptoms, my opinion as diff.dg is esophageal achalasia.

    8. Sherif says:

      Widened mediastinum with anterior displacement of trachea so mass is posterior mediastinal with double density of the aortic arch on lateral view so mass may encroach on middle mediastinum. DD broncogenic cyst
      Esophagenal tumor
      Aortic aneurysm

    9. Jolanta says:

      Εsophageal achalasia

    10. Georgios says:

      Double aortic arch

    11. sht says:

      double aortic arch with vascular ring