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Joseph Junewick, MD FACR
over 10 years ago
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Middle mediastinal mass secondary to aneurysm of aorticopulmonary collateral

Case Detail

Anatomy: Chest
Joseph Junewick, MD FACR
Diagnostic Category: Vascular
Created: over 11 years ago
Updated: over 4 years ago
Modality/Study Types: CT CR
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39 year old male with back pain after fall.

Case Images


Aneurysm of aorticopulmonary collateral.


CXR – rounded right mid-thoracic paraspinal mass

CT – atherosclerosis and mural thrombus associated with aneurysmal dilation of a aorticopulmonary collateral artery.


The azygoesophageal recess is the interface between the right lung and the mediastinal reflection inferior to the arch of the azygos vein, with the esophagus lying anteriorly and the azygos vein posteriorly within the mediastinum. At radiography, this interface is seen as an edge, occasionally with a right convex bulge along the mid portion related to the right pulmonary vein confluence. Differential considerations for a lesion in this area would be duplication or bronchogenic cyst, cardiac or pericardial abnormality, adnenopathy, and vascular anomaly. The usual vascular anomaly in this middle mediastinal mass differential would be for aortic aneurysm, however this case represents an unusual vascular consideration.


Written CR, Khan S, Munneke GJ et al. A Diagnostic Approach to Mediastinal Abnormalities. RadioGraphics (2007); 27:657– 671

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