There is a large superior / anterior mediastinal mass seen projecting predominently to the left side of the midline and in close contact with the aortic knuckle. On CT, the mass shows some peripheral enhancement and appears to displace the carotid vessels. The differential would include (1) lymphoma (2) teratoma (3) thymic tumour (4) thyroid tumour (or goitre). This was found to be lymphoma on biopsy.

Reference: Camilla R. Whitten, Sameer Khan, Graham J. Munneke, and Sisa Grubnic A Diagnostic Approach to Mediastinal Abnormalities. RadioGraphics 2007; 27: 657-671.

Credit: Dr Abhijit Datir