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A left para-hilar irregular and spiculated, mildly enhancing soft tissue mass lesion is seen extending to the aorto-pulmonary window. It measures 5.5 X 4 X 3 cm in its main CC and axial diameters. The lesion is associated with desmoplastic reaction of the left upper lobe.
Small pre-carinal and pre-vascular lymph nodes are seen with the largest measuring 2 X 1.5 cm.
Enlargement of the left piriform sinus with mild antero-medial deviation of the arytenoid cartilage as well as relative widening of the left laryngeal ventricle and mild thickening and adduction of the left aryepiglottic fold indicative of left vocal cord paralysis.
Left vocal cord paralysis secondary to left parahilar malignant mass lesion (mostly bronchogenic carcinoma).