CLINICAL IMAGAGINGAN ATLAS OF DIFFERENTIAL DAIGNOSISEISENBERG

1. 27 Posterior Mediastinal Lesions

2. CLINICAL IMAGAGING
AN ATLAS OF DIFFERENTIAL DAIGNOSIS
EISENBERG
DR. Muhammad Bin Zulfiqar
PGR-FCPS III SIMS/SHL

3. • Fig C 27-1 Neurogenic tumor. (A) Frontal and
(B) lateral views of the chest demonstrate a
large right posterior mediastinal mass.42

4. • Fig C 27-2 Aneurysm of the descending aorta.
(A) Frontal view of the chest demonstrates a
localized bulging of the descending aorta
(arrows). (B) Lateral view in another patient
shows aneurysmal dilatation of the lower
thoracic aorta (arrows). Note the marked
tortuosity of the remainder of the descending
aorta.

5. • Fig C 27-3 Hiatal hernia. (A) Frontal and (B)
lateral views of the chest demonstrate a huge
air-filled hiatal hernia that appears as a
posterior mediastinal mass (arrows).

6. • Fig C 27-4 Megaesophagus. Lateral chest film
in a patient with achalasia shows a mixture of
fluid and air density in the dilated esophagus
(arrows).

7. • Fig C 27-5 Esophageal varices. (A) Frontal chest
radiograph in a patient with severe cirrhosis
shows a retrocardiac mass (arrows) that
silhouettes the descending aorta and causes
abnormal convexity of the azygoesophageal
recess. (B) Corresponding MR image reveals
extensive paraesophageal vascular channels
consistent with varices.19

8. • Fig C 27-6 Neurenteric cyst. (A) Frontal and (B)
lateral views of the chest demonstrate a large,
oval, homogeneous mass in the posterior
mediastinum. Note the right
hydropneumothorax (arrows) with a long air-
fluid level that developed as a complication of
a diagnostic needle biopsy.

9. • Fig C 27-7 Tuberculous osteomyelitis of the spine.
Large paravertebral abscess produces a fusiform
soft-tissue mass about the vertebrae (arrows).
There is poorly marginated destruction along
with loss of the superior and inferior end plates
of the T9 vertebral body.

10. • Fig C 27-8 Azygos continuation of the inferior
vena cava. (A) On the frontal view, there is an
irregular paravertebral mass (arrows). (B)
Lateral view shows pulmonary vessels in the
retrocardiac space but no shadow of the
inferior vena cava.