Metastases - the clincher is the rib lesion (i.e. multiple systems are involved). Even without the rib lesion, the favoured diagnosis would still be metastases from a primary lung cancer given the large right paratracheal mass.
Right paratracheal mass with right upper lobe volume loss. Innumerable pulmonary nodules throughout both lungs. A large mass projects over the cardiac silhouette. Expansile lesion of the left posterior 5th rib.