PMC9210193_01
Radiograph of the neck, anteroposterior (a) and lateral (b), demonstrates anterior displacement of the airway and oesophagus (thick arrow) and widening of the prevertebral soft tissue (thin arrow). The frontal chest radiograph (c) indicates displacement of the right paraspinal stripe (thin arrows) and a retrocardiac opacity (thick arrow) indenting (curved arrow) the gastric fundus (asterisk).
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F0001
A radiograph of the neck and cervical spine was obtained (Figure 1a and b), which indicated thickened prevertebral soft tissue causing anterior displacement of the airway. A chest radiograph acquired at the same time (Figure 1c) revealed a homogenous opacity causing displacement of the right paratracheal stripe and thickening of the paravertebral stripe.
Axial contrast-enhanced CT scan of the neck, at the level of the hyoid bone (a) and at the level of sixth cervical vertebra (b), reveals a peripherally enhancing cystic lesion (thin arrows in a and b) involving the retropharyngeal and prevertebral space with extension to the anterior cervical and visceral space (thick arrow in b).
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F0002
It revealed a hypodense peripherally enhancing cystic lesion involving the prevertebral and retropharyngeal spaces of the neck, extending from the base of the skull to the level of the thoracic inlet (Figure 2a and b).
Axial sections of contrast-enhanced CT scan of the chest and abdomen (a-d) show the pseudocyst in the visceral compartment of the mediastinum abutting the superior vena cava (curved arrow in a) and descending thoracic aorta, with anterior displacement of the oesophagus (curved arrow in c). It is extending into the abdomen through the oesophageal hiatus (white arrow in c) where it is seen arising from the body of pancreas (white arrow in d). Ascites (curved arrow in d), bilateral pleural effusions and left lower lobe consolidation (asterisk in c) are also noted.
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F0003
Further caudally, it was seen to extend into the mediastinum, involving the visceral compartment, causing anterior displacement of the trachea and oesophagus (Figure 3a-c). More distally, the lesion was seen to extend through the oesophageal hiatus of the diaphragm into the abdomen, involving the lesser sac and body of pancreas (Figure 3d).