Correct!
1. Contrast-enhanced thoracic CT

Repeat frontal chest radiography is not likely to be beneficial as the abnormality detected at presentation chest radiography is very unlikely to represent artifact. Pulmonary function testing could prove useful for physiologic assessment, but it is unlikely that pulmonary function testing would provide information that would either localize the lesion detected at presentation chest radiography or indicate its etiology. Either mediastinoscopy or flexible fiberoptic bronchoscopy may play a role in the evaluation of this patient, but further efforts to localize the lesion prior to invasive interventions are required. In this regard, thoracic CT, preferably performed with intravenous iodinated contrast, would be the most useful procedure to provide information regarding the etiology of the chest radiographic findings.

The patient underwent unenhanced CT of the thorax (Figure 3).

Figure 3. Panels A-I: Representative images from axial unenhanced thoracic CT. Right: video of thoracic CT.

Which of the following is correct regarding the description of the thoracic CT findings? (Click on the correct answer to proceed to the fourth of seven pages)

1. CT shows a focal lesion projecting into the right superior mediastinum
2. CT shows loculated pleural fluid and thickening in the right anterior-superior thorax
3. CT shows multifocal mediastinal lymphadenopathy
4. CT shows that an aneurysm of the right brachiocephalic vein accounts for the chest radiographic abnormality
5. CT shows that the lesion seen at chest radiography is a variant pericardial recess

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