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The cardiomediastinal contour is markedly abnormal. There is abnormal nodular expansion of the left side of the superior mediastinum, involving the soft tissues adjacent to the aortic knuckle which is indistinct; the aortopulmonary window which is expanded and the left side of the heart. The trachea is displaced to the right that does not appear significantly narrowed in this projection. The cause for this is unclear however differential diagnosis includes an abnormal mediastinal soft tissue mass or lymphadenopathy. Further evaluation with a CT scan through the chest is required.
The heart size is difficult to assess. There is mild apparent elevation of the left hemidiaphragm. The underlying lungs and pleural spaces are clear. No evidence of free subphrenic gas.