Correct!
2. The enhanced neck CT shows destruction of the tracheal wall
The enhanced neck CT shows a mass centered in the left paratracheal region at the thoracic inlet. The mass is associated with destruction of the left lateral tracheal wall (Figure 6).
Figure 6. Axial (A) and coronal (B) enhanced neck CT shows a soft tissue mass centered in the left paratracheal region at the thoracic inlet, accounting for the chest radiographic findings. The lesion shows faint, nodular internal enhancement (arrowhead) and is associated with destruction of the left lateral wall of the trachea (arrow).
The mass minimally contacts the anterior margin of the esophagus, but the bulk of the lesion is centered anterior to the esophagus and therefore probably does not arise from the esophagus itself. A large focus of metastatic lymphadenopathy is technically possible, but an isolated metastatic nodal mass centered in the left paratracheal region at the thoracic inlet in the setting of otherwise normal chest radiography would be distinctly unusual. The mass shows some faint internal enhancement, indicating that the lesion is not a simple cyst. The enhancement, however, is not suggestive of aneurysm, and the contact of the lesion with the left subclavian artery is minimal, making pseudoaneurysm unlikely as the origin of this lesion.).
Which of the following choices is the least appropriate consideration for the differential diagnosis of this lesion? (Click on the correct answer to proceed to the eighth of nine pages)