Short and sweet. There is a fluid density lesion present in the right paratracheal region. The key feature here is the absence of any peripheral soft tissue to suggest a necrotic node, homogeneous fluid attenuation and the moulding nature of this lesion to the trachea and great vessels. The diagnosis may be confirmed on multidetector CT by demonstrating communication to the typically crescentic shaped retroaortic posterior pericardial recess on 1mm reconstructed axial images or on coronal imaging (see below). Incidence is unknown, but probably far less than the 2% figure quoted in the only paper to review a series.
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