Chest Computed Tomography showing extensive prominent bulky heterogenous lymph nodes in the anterior and middle mediastinum (measures 8 cm in AP dimension and 7 cm transversely), including involvement of the pre-tracheal and perivascular spaces. As a result of the extensive involvement, there is significant narrowing of the left brachiocephalic vein as it traverses the mediastinum. There is also narrowing of the superior vena cava. No clear evidence of hilar adenopathy.