An Abnormal Chest x-Ray

A 51-YEAR-OLD white man with a 45-year history of smoking was noted to have an abnormality on a routine chest x-ray. He denied any history of cough, sputum production, chest pain, dyspnea, weight loss, weakness, or tuberculosis. There was no previous chest x-ray available for comparison. The patient's physical examination results were unremarkable. His chest x-ray is shown in Figure 1and a computed tomographic (CT) scan of his chest is shown in Figure 2.

Figure 1. 

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Figure 2. 

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1. Morgagni hernia

2. Right middle lobe tumor

3. Pericardial cyst

4. An anterior mediastinal mass