A 63-year-old woman with a 2-month history of dyspnea

(CHEST 2000; 117:1505‐1507) A 63-year-old woman presented with a 2-month history of progressive dyspnea and a 5-kg weight loss. She had no cough, hemoptysis, or chest pain. There was no history of anorexia, diarrhea, or abdominal pain. She had a 20-pack-year history of smoking but had stopped 20 years prior to presentation. The patient’s medical history was otherwise unremarkable. On physical examination, mucous membranes, temperature, pulse rate, respiratory rate, and BP were normal. The results of auscultation of the lung and heart were normal. There were no abdominal, rectal, or breast masses palpated, and there was no adenopathy. All laboratory tests, including WBC count, RBC count, and hemoglobin level, were normal. The chest radiograph showed a well-circumscribed soft-tissue mass overlying the left hilum (Fig 1). Contrast-enhanced chest CT revealed a solitary periaortic mass of heterogeneous attenuation in the posterior aspect of the left hemithorax. The mass displaced the left lower lobe bronchus and partially encased the descending aorta (Fig 2). There were no other parenchymal abnormalities, mediastinal or hilar adenopathies, or pleural effusions. The results of transbronchial and transthoracic needle aspiration biopsies of the mass were nondiagnostic. A videoassisted thoracoscopic lung biopsy was performed.