Thorax 2007;62:192; doi:10.1136/thx.2006.064154
Copyright © 2007 BMJ Publishing Group Ltd & British Thoracic Society
Multiple thoracic osteophytes presenting as mediastinal mass
Annemarie Sykes1,
Rekha Badiger1,
John Wort1,
Susan Copley2
1 Department of Respiratory Medicine, Hammersmith Hospital, London, UK
2 Department of Radiology, Hammersmith Hospital, London, UK
Correspondence to:
Correspondence to:
Dr A Sykes
Department of Respiratory Medicine, Hammersmith Hospital, Du Cane Road, White City, London W120HS, UK; annysykes{at}doctors.org.uk
A 59-year-old builder presented to the accident and emergency department with a 4-week history of intermittent central chest pain. He was a lifelong non-smoker, had no asbestos or tuberculosis exposures, and had no cardiac risk factors. The patients pain settled with simple analgesia. Chest x ray showed a widening of the right paratracheal stripe consistent with right paratracheal lymphadenopathy (fig 1
). Reassuringly, the computed tomography scan revealed prominent thoracic vertebral osteophytes (figs 2
and 3
).
Cervical osteophytes have been reported to be associated with respiratory compromise, airway obstruction and dysphagia. Extra spinal manifestations of thoracic osteophytes have been reported infrequently, but single large osteophytes have been associated with bronchial obstruction and recurrent infection.
This case demonstrates that multiple thoracic osteophytes can resemble an anterior mediastinal mass on chest x ray and should be part of the differential diagnosis. To the authors knowledge, this is the first reported case of osteophytes resembling paratracheal lymphadenopathy.
References
- Aronowitz P, Cobarrubias F. Anterior cervical osteophytes causing airway compromise. N Engl J Med 2003;349:2540.[Free Full Text]
- Leon J, Calamia K, Leventhal JP. Chronic obstructive pneumonia caused by a vertebral body osteophyte. Mayo Clin Proc 2000;75:1858.[Medline]
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Copyright © 2007 BMJ Publishing Group Ltd & British Thoracic Society