There is a large, infiltrative, malignant-appearing lesion which appears to be centred in the anterior and superior right mediastinum. The lesion appears to be invading the inferior aspect of the superior vena cava which appears either occluded or subject to a very high-grade stenosis secondary to tumour thrombus here. SVC obstruction is present with signs of collateral circulation hypertrophy. The lesion also appears to be invading into the right atrium. It exerts quite marked compressive mass effect on the structures of the superior mediastinum compressing in particular the right main pulmonary artery, which has a maximum AP dimension of approximately 4 mm at its narrowest point as a result. There is some mild compression exerted on the carina and the right and left main bronchi. The aorta is displaced from right to left.
There is bland thrombus present in the superior vena cava above the tumour thrombus and bland thrombus present within the brachiocephalic vein. The bland thrombus extends into the external and anterior jugular veins on the left. There is bland thrombus in the inferior aspect of the IJV on the right.
The remainder of the chest and neck are unremarkable.