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Answer: 4. Thoracic CT shows a mass in the para-aortic and subaortic space

A soft tissue mass is present lateral to the aortic arch, within the para-aortic space (lateral to the aortic arch), extending inferiorly to the space anterior to the main pulmonary artery and lateral to the left pulmonary artery, and medial to the origin of the first branch of the left pulmonary artery- the subaortic space.

No other aggressive appearing abnormalities were seen on this study. Which procedures would be potentially useful for establishing a diagnosis for this lesion?

  1. Percutaneous fine needle aspiration biopsy
  2. Endobronchial ultrasound with fine needle aspiration biopsy
  3. Endoscopic ultrasound with fine needle aspiration biopsy
  4. Left anterior medastinotomy (Chamberlain procedure)
  5. Standard cervical mediastinoscopy
  6. More than one of the above

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