Normal lymph nodes mimicking a mediastinal mass during transesophageal echocardiography

We report a transesophageal echocardiographic (TEE) study in an adult patient with ischemic stroke, in whom a nodular mass lesion consistent with tumor or mediastinal lymphadenopathy appeared to be interposed between the esophageal probe and the proximal descending aorta/aortic arch. Computed tomography (CT) scan of the chest revealed no pathologic lesions, only the presence of normal mediastinal lymph nodes and a rightward displaced esophagus. This unusual, but normal rightward position of the esophagus appears to have facilitated the visualization of these normal mediastinal lymph nodes on TEE. CT scan of the chest helped clarify the benign nature of these lymph nodes, which mimicked a mediastinal mass on TEE.