Anterior mediastinal mass - lymphoma

Case contributed by Frank Gaillard
Diagnosis almost certain

Patient Data

Age: Adult
Gender: Male

Chest x-ray


Frontal chest x-ray demonstrates a large soft tissue density on the right side. It obliterates the normal silhouette of the SVC and right heart border. Hilar vessels can be seen through the mass. The rest of the lungs and the pleura appear unremarkable. 

Chest x-ray


Lateral chest x-ray confirms the mass to be arising anteriorly.

Hilum overly sign - annotated

Annotated image

The ability to visualize pulmonary vessels through the mass implies that it is located either anterior or posterior to the hilum, but not at the hilum. This is known as the hilum overlay sign. 

Case Discussion

This x-ray elegantly demonstrates the features of an anterior mediastinal mass. 

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