A good case for long case or viva of a fellowship examination.

Start with the plain film to assess:

• the candidate's approach to a common film
• their understanding of how to determine mediastinal compartment the pathology lies in
• knowledge to give a reasonable differential diagnosis
• to 'earn' the CT to give a more confident definitive diagnosis
• question on the best method of ascertaining a tissue diagnosis

Additional discussion of US-guided neck node biopsy vs surgical excision vs CT-guided mediastinal mass biopsy.