A "must not miss film" whether in an exam or real life. This is lung cancer until proven otherwise. In the exam:
- Describe findings.
- State, "I am concerned this may represent a malignancy and warrants further investigation."
- State, "Necessity to refer urgently to a respiratory physcian with a view to CT and bronchoscopy."
This is the reason the retrocardiac space is one of the review areas for all chest x-ray interpretations.