A node or not a node; that is the question?

A node or not a node; that is the question? Case history A 40-year-old woman was referred to the respiratory assessment clinic with a history of sudden onset, right-sided, posterior chest pain. The pain was noted to be exacerbated by respiratory excursion. She had a history of well-controlled asthma and seronegative arthritis for which she was being treated with methotrexate and depomedrone. No specific abnormal examination findings were found, vital signs were normal and a D-dimer was noted to be negative. A chest radiograph (CXR) suggested abnormal soft tissue in the right paratracheal area. Computed tomography (CT) pulmonary angio-gram showed no evidence of pulmonary embolism but confirmed an ovoid right paratracheal lesion Figures 2. MRI of right paratracheal mass (arrowed). Low signal on both (A) T1-weighted fat-suppressed images and (B) T1-weighted images following intravenous gadolinium but high signal on (C) T2 weighted. These findings are characteristic of a simple cyst. Figure 1. CT (mediastinal window settings) showing right paratracheal mass.