Presentation
Shortness of breath.
Patient Data
The cardiac contour is within normal limits. There is enlargement of the right superior mediastinal contour with tracheal displacement to the left. The lungs and pleural spaces are clear.
There is diagnostic contrast opacification of the pulmonary arteries. There is no evidence of pulmonary embolus. Right thyroid lobe is enlarged and extends down beside the trachea until the right main pulmonary bronchus, circumscribed, and exhibiting heterogeneous attenuation with some scattered central calcifications. There is mild leftward displacement of the trachea and esophagus, anterior compression over the superior vena cava, and compression over the lung right upper lobe. Subtle mosaic attenuation pattern in the lower lobes. Lungs are otherwise unremarkable. The pleural spaces are clear. There is no lymph node enlargement.
Case Discussion
This case illustrates a large right thyroid lobe goiter with retrosternal extension into the right chest apex and the mediastinum, as well as associated tracheal deviation and compression. It has been further confirmed histologically.
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