Bulky large anterior mediastinal mass with necrotic foci. Malignant nodular pleural thickening encasing the right hemithorax also involving the pericardium, with a small pericardial effusion. No convincing transgression of the right hemidiaphragm by tumour.
Multiple right-sided pulmonary nodules consistent with metastases.
Compensatory hyperinflation of the left lung. No left lung nodules or pleural disease.
No concerning findings beneath the diaphragm; prominent focal hepatic fat adjacent to the fissure for the ligamentum venosum.
Conclusion:
Invasive mediastinal mass with direct involvement of the pleura, pericardium, and multiple pulmonary metastases. No distant metastases of the contralateral lung or extrathoracic structures.