Aortic Arch Aneurysm
Pathophysiology: The commonest causes of thoracic aortic aneurysms are atherosclerosis and trauma. The obvious risk is sudden hemorrhage and death thus close clinical and radiological follow-up with elective surgical repair (if necessary) are the goals.
Clinical Clues: clinical history of hypertension and diabetes.
CXR Findings: high riding aortic arch
Contrast enhanced CT of the chest with an aortic protocol is the ideal imaging modality for assessment.
CT images on left are from a patient with previous aortic stent inserted.
"Aunt Sophies":
- Left upper lung masses and tumors
- Left upper lobe pneumonia or atelectasis
- Superior mediastinal masses projection to the left eg. thymoma, teratoma
- Left mediastinal adenopathy: eg. lymphoma, metastases
- Pleural and extrapleural collections eg. empyema, hematoma
- Marked destruction of the bony thorax with inflammatory reaction: eg. bony metastases or tumor, osteomyelitis, Pott's disease
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