Right Aortic Arch Versus Mediastinal Tumors and Densities: Diagnostic Problems  EMANUEL SCHWARTZ, M.D., F.C.C.P., HENRY H. KALTER, M.D.  Diseases of the Chest  Volume 28, Issue 1, Pages 91-97 (July 1955) DOI: 10.1378/chest.28.1.91 Copyright © 1955 The American College of Chest Physicians Terms and Conditions

Figure 1 (Case 1) J. P.: Right aortic arch with left descending aorta. Aortic tortuosity causing right mediastinal density. (A) P. A.—Large dense semicircular shadow in right mediastinum. (B) Right lateral view—Esophagram: Aorta displaces esophagus and trachea markedly forward. Diseases of the Chest 1955 28, 91-97DOI: (10.1378/chest.28.1.91) Copyright © 1955 The American College of Chest Physicians Terms and Conditions

Figure 2 (Case 2) F. H.: Right aortic arch with left descending aorta-azygos lobe. (A) P. A.—Heart slightly enlarged to left. Mediastinal aortic silhouette somewhat widened and elongated, its right upper border fusing with azygos lobe. (B) Right Lateral View—Retro-esophageal aorta displaces esophagus and trachea considerably forward. Diseases of the Chest 1955 28, 91-97DOI: (10.1378/chest.28.1.91) Copyright © 1955 The American College of Chest Physicians Terms and Conditions

Figure 3 (Case 3) M. S.: Old Healed Pulmonary Tuberculosis—Right aortic arch with left descending aorta. (A) P. A.—Pulmonary Fibrosis in apical-posterior segment of left upper lobe; aorta generally dilated and elongated. (B) Esophagram P. A. x-ray—The esophagus is considerably displaced to the left by a round, dense mediastinal shadow, representing a right aortic arch. Diseases of the Chest 1955 28, 91-97DOI: (10.1378/chest.28.1.91) Copyright © 1955 The American College of Chest Physicians Terms and Conditions

Figure 4 (Case 4) E. W.: Right aortic arch with left descending aorta. (A) Esophagram P. A. x-ray—Double lobed, bilateral upper mediastinal shadow. The esophagus is markedly impinged on its right border and displaced to the left by the right aortic arch, represented by the right mediastinal density. The density in the left mediastinum has an osseous appearance and a dense bony border and represents the left side of the manubrium sterni. (B) Esophagram right anterior oblique position—The esophagus is displaced anteriorly by the right aortic arch. Diseases of the Chest 1955 28, 91-97DOI: (10.1378/chest.28.1.91) Copyright © 1955 The American College of Chest Physicians Terms and Conditions

Figure 5 (Case 5) H. R.; Healed tuberculosis, lateral segment of right middle lobe. Double lobed, bilateral upper mediastinal density. The esophagram was normal. The right upper part of the density has an osseous structure and represents the right side of the manubrium sterni. The left and lower part of the mediastinal density proved to be the normal aortic knob. Diseases of the Chest 1955 28, 91-97DOI: (10.1378/chest.28.1.91) Copyright © 1955 The American College of Chest Physicians Terms and Conditions

Figure 6 (Case 6) H. K.: Enlarged Tuberculous Lymph Nodes in Right Upper Mediastinum. (A)—Two right mediastinal densities diagnosed as enlarged tuberculous lymph nodes. (B)—Resolution of the upper mediastinal density following antituberculous therapy. Lower density persists simulating right aortic arch. Diseases of the Chest 1955 28, 91-97DOI: (10.1378/chest.28.1.91) Copyright © 1955 The American College of Chest Physicians Terms and Conditions

Figure 7 (Case 7) J. S.: Boeck's Sarcoid. Enlarged lymph node in right upper mediastinum simulating right aortic arch. Diseases of the Chest 1955 28, 91-97DOI: (10.1378/chest.28.1.91) Copyright © 1955 The American College of Chest Physicians Terms and Conditions