case_images: PMC10916488_01
case_images: Mediastinal mass (7.4 cm) with eccentric calcifications resulting in a mass effect on the right pulmonary artery.
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case_images: It ruled out pulmonary embolism but showed a 7 x 4.5 x 3.5 cm subcarinal mass or lymphadenopathy with small punctate calcification, resulting in a mild mass effect on the adjacent right main pulmonary artery (Figure 1).
case_images: Subcarinal lymphadenopathy with purulence as seen on bronchoscopy.
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case_images: Soon after the clinic visit, he underwent bronchoscopy with EBUS-TBNA; the procedure demonstrated copious purulence with erosion of the subcarinal mass (Station 7 lymph node) through the right and left sides of the main carina (Figure 2), which was all drained and aspirated several times using a dedicated 21-gauge FNA needle, around 10 mL of pink purulent fluid was aspirated.
case_images: Avid FDG uptake in subcarinal lymph node indicating infection.
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case_images: A positron emission tomography (PET)-CT scan showed localized fluorodeoxyglucose (FDG) avid uptake in the subcarinal lymph node, indicating an infection (Figure 3).
case_images: Almost complete resolution of the mediastinal mass and associated calcifications.
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case_images: A 3-month follow-up CT chest showed complete resolution of subcarinal adenopathy and calcifications but persistent calcified lymph nodes in the right hilum (Figure 4).