title: Left hilar mass with obstruction of the main bronchus due to localized pseudoaneurysm of the thoracic aorta.
abstract: The left hilum is an anatomically complex region. It is poorly imaged on conventional chest roentgenography and even on tomography. A wide range of diagnoses must be considered upon discovery of a hilar mass. In this report, the authors discuss their experience with a potentially hazardous hilar mass found in a 61-year-old man with a 40 pack-year smoking history. The mass, which was identified as an aortic pseudoaneurysm, caused near-total obstruction of the left main bronchus. The aneurysm was successfully repaired and patency of the bronchus restored. Radiographic features that suggest an aortic aneurysm as a cause of a hilar mass include posterior location and lack of associated mediastinal or contralateral hilar adenopathy. Computer tomography with contrast will readily define a vascular hilar mass. If cancer or lymphoma are suspected as the cause of a hilar mass, mediastinal lymph-node imaging, and aspiration or biopsy are indicated.
authors.affiliation: Division of Cardiothoracic Surgery, Queen's University, Kingston, Ont.
authors.forename: J M
authors.initials: JM
authors.lastname: Lukanich
authors.forename: A A
authors.initials: AA
authors.lastname: Conlan
mesh_terms: D017541:Aneurysm, False / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D017545:Aortic Aneurysm, Thoracic / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000209:etiology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed