Discussion

This radiograph shows a paramedian mass in the right lung apex, colloquially referred to as a Pancoast tumor. The sharp margin and obtuse angle formed with the lung favors a pleural or extrapleural location. The lateral margin of the mass is visible above the clavicle, which localizes the mass to the posterior mediastinum (negative cervicothoracic sign). The patient is slightly rotated to the left. Multiple healed bilateral rib fractures are present. A nipple ring projects over the left hemithorax.