Presentation
Shortness of breath.
Patient Data
Right paratracheal mass, otherwise normal.
Conglomerate right paratracheal lymph nodes forming a large mass displacing the superior vena cava anteriorly and the trachea to the left. Other mildly enlarged lymph nodes throughout the mediastinum. Mild paraseptal/centrilobular emphysema, no suspicious lung nodules. Airways patent, no pleural effusion, no edema/pneumonia.
Case Discussion
The normal right paratracheal stripe is a thin < 4 mm soft tissue density line that forms where the soft tissue density right tracheal wall contacts the air density right lung. Malignancy is a common cause of stripe thickening. Lymph node biopsy in this case showed squamous cell carcinoma, thought to have arisen from the lung although no lung nodule/mass was present.