PMC6554485_01
Chest radiograph (PA) view showing a lesion around aorta.
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The chest radiograph revealed a left upper zone lesion demonstrating a negative silhouette sign with the arch of aorta suggestive of a lung mass versus a posterior mediastinal mass (Fig. 1).
a: Computed tomography (CT) of chest lung window in axial cut at the level of trachea showing mass around the major vessels in the mediastinum. b: CT of chest axial cut mediastinal window at the level of trachea showing mass around the major vessels in the mediastinum. c: CT of chest mediastinal window with the blue circle demarcating the esophagus, red circle demarcating the pulmonary artery, purple fill demonstrating the mass lesion and the black arrow showing the path taken by the needle. (For interpretation of the references to colour in this figure legend, the reader is referred to the Web version of this article.)
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It was attached to mediastinal pleura and aortic arch (Fig. 2a and b). EBUS was not feasible because the tumour bronchus sign was negative. EUS-B was planned, as there was a safety window via the esophageal route (Fig. 2c).
Endosonographic view of the EUS-B scope showing needle in the mass traversing through the subclavian artery.
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We traversed through subclavian artery and reached the mass (Fig. 3).