Lesions of the thoracic aorta and its arch branches simulating XXXX .

@entity1 @entity32 @entity455 @entity101 @entity5 @entity439 @entity731 @entity715
Abnormal radiographic densities in the midportion of the chest are most commonly caused by @entity5 , cysts, or @entity32 . However, @entity455 may present an identical x-ray appearance, with no distinguishing clinical history or physical findings. The cardiothoracic surgeon must be aware of this similarity in order to ensure the most appropriate diagnostic and therapeutic approach. In our experience, the most frequent problem in differential diagnosis is a lesion of the thoracic aorta or its arch branches simulating @entity5 . Nine such cases are presented, with pertinent conventional radiographs angiograms, and computed tomographic (CT) scans. These are considered in anatomic sequence: (1) ruptured sinus of @entity439 ; (2) ascending aortic @entity439 ; (3) tortuosity or @entity439 of the innominate and subclavian arteries; (4) transverse arch @entity439 ; (5) pseudocoarctation; and (6) descending aortic @entity439 . Such @entity455 must be considered early in the evaluation of any juxta-aortic chest density, particularly if the @entity1 is @entity101 and has other manifestations of @entity731 . Angiography and computed tomography establish the diagnosis in most instances, although both are less reliable when @entity715 fills all or part of an @entity439 . If these methods fail to establish a vascular origin, the possibility of @entity5 is pursued. When neither a vascular nor neoplastic origin can be proved, surgical exploration is indicated in the otherwise good-risk @entity1 .
