Postmediastinoscopy changes in the chest radiograph

A series of 50 postmediastinoscopy erect portable films was reviewed and compared with 100 normal control films to determine how often changes might develop after mediastinoscopy that could simulate mediastinal adenopathy. Such findings were found in 54% of postmediastinoscopy patients; they consisted of a thickened right paratracheal stripe (RPS) in 30%, a right paratracheal mass in 22%, and a left superior mediastinal mass in 4%. These changes usually resolve in a few days, but they may cause an initial erroneous impression of mediastinal adenopathy if recent previous films are not available for comparison. An indistinct RPS without a right paratracheal mass was found in 47% of control erect portable radiographs and was not considered a relevant finding.