EXAMINATION: CT Thorax(with HRCT)(Plain+Contrast)
Persistent coughing x 6/12,private CXR showed left hilar shadow
Plain and contrast MDCT of thorax performed.
Anatomical coverage:Thoracic inlet to adrenal region
Data acquisition:1.25 mm
Reconstruction for filming:5 mm soft tissue, 5 mm in lung window
Suboptimal study because patient cannot hold breath well.
A 5.1 x 5.3 x 5.8cm(AP x TS xCC)anterior mediastinal mass with well-defined lobulated border is noted.Calcific foci are seen inside it.No fat density is seen inside.It shows homogeneous enhancement after contrast.It is contiguous with ascending aorta and pulmonary tunk posteriorly.
Multipe tree-in-buds lesions are seen in right upper and middle lobe.
The lung volumes are preserved. No consolidation seen.No pulmonary mass can be identified.The trachea and bronchi are patent. No bronchiectasis.
There is nopleural thickening or effusion seen.
Mildly preminent precarinal(1.7 x 0.7cm),subcarinal(0.7 x 1.3cm)and right hilar(1.8 x 1.3cm)lymph nodes are seen possibly reactive.
The heart is not enlarged.
No sign of acute heart failure.
Both adrenal glands are normal in size and the adrenal crura are normal in appearance.
The rest of the viscera in scanned portion of the upper abdomen are unremarkable.
Anterior mediastinal mass possibly of thymic origin like thymoma.Suggest clinical correlation.Histological confirmation may be helpful if clinically indicated.
Multiple tree-in-buds lesions are seen in right upper and middle lobe in favor of small airway disease.Infection like endobronchial tuberculosis may have to be excluded.
Mildlly mediastinal lymph nodes possibly reactive.