CTICasesCervicothoracic Sign Localizing a Substernal Goiter
Imaging findings
Chest radiograph shows a well-defined interface along the left superior mediastinal margin that disappears at the level of the thoracic inlet as it no longer contacts aerated lung, with mild rightward tracheal displacement; the lateral view confirms the abnormality is not posterior but rather traverses the thoracic inlet. CT confirms a paratracheal mass extending into the left superior mediastinum, distinct from and displacing the adjacent left subclavian artery.
Key takeaways
A well-defined mediastinal interface that disappears at the thoracic inlet -- the cervicothoracic sign -- localizes a lesion to the thoracic inlet/neck rather than the posterior mediastinum, since only structures contacting aerated lung produce a sharp radiographic border; the most common cause of this sign is a substernal goiter, confirmed here on CT.
AI-assisted summary — may contain errors. Verify against the source video. Learn more
More from this webinar
- Azygos Continuation of the IVC with Bilateral Hyparterial Bronchi and Polysplenia-like AnatomyCongenital
- Extrapleural Fat Hyperplasia in Chronic Diffuse Pleural DiseaseArtifact
- Primary Pericardial MesotheliomaNeoplastic
- Tracheal Involvement of Granulomatosis with Polyangiitis (GPA)Autoimmune
- Multiple Cardiac Myxomas in Carney ComplexNeoplastic
- Constrictive Pericarditis with Circumferential Pericardial CalcificationInflammatory
- LVAD Outflow Graft Extraluminal Debris Causing Low-Flow AlarmsArtifact
- Iatrogenic Tracheal Rupture from an Overinflated Endotracheal Tube BalloonIatrogenic
See all cases from March 23, 2018 →
Related Neoplastic cases
- Extraosseous (Extramedullary) Multiple Myeloma with Paraspinal and Soft-Tissue Masses
- Tracheobronchial Papillomatosis Associated with HPV-Positive Squamous Cell Carcinoma
- Pulmonary Tumor Embolism from Hepatocellular Carcinoma
- Diffuse Pulmonary Meningotheliomatosis
- Cardiac Hemangioma
- Pulmonary Amyloidosis and Marginal Zone Lymphoma in Sjogren's Syndrome