Case 9 – update 2

*For start of case see https://teamhaem.wordpress.com/2013/05/07/case-9-may-2013/ *

The radiographer doing the X-ray notices the abnormality and calls the GP immediately to review the patient.  On review, the patient is the same as she has been for the past few weeks.  She has no obvious venous distension.  Nevertheless the GP is concerned about superior venacaval obstruction.  The GP calls the respiratory registrar who agrees to see the patient the next day for further investigations.

Questions:

  • What are the differential diagnoses or a mediastinal mass?
  • Would you do a lateral or just go straight to CT scan?

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