Vol. 3 No. 1 (2023): Vol. 03 No. 1 (2023)

A patient who presented with sudden shortness of breath, stridor, and recurrent laryngeal nerve paralysis was diagnosed with a tracheal diverticulum. The diagnosis was established through CT scans and confirmed via endoscopy. Distinctive CT findings revealed an air-filled, tubular structure located behind and slightly to the right lateral of the trachea, which communicated with it. Endoscopy demonstrated a narrow-mouthed diverticulum originating from the posterior right wall of the trachea, approximately 8 cm below the level of the true vocal cords. Successful medical treatment was administered, and the patient experienced an uncomplicated recovery.

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Conducting a CT-guided interventional procedure involving retrosternal pleural hydro-dissection of the juxta-aortic anterior mediastinum under local anesthesia revealed a rare histopathological condition known as benign mediastinal sclerosis. This challenging CT-guided intervention within the anterior mediastinum is scarcely documented in the existing scientific literature. In this presentation, we share our case along with relevant clinical data. What makes this case distinctive is that the clinicians initially questioned the representativeness of the biopsy sample we obtained. Consequently, an additional sample was acquired through a highly invasive video-assisted mediastinoscopy procedure under intubation anesthesia. Remarkably, this second sample yielded the same histopathological result.

Mediastinal sclerosis is an exceedingly rare condition, often referred to as the "burnt-out" stage of sclerosing mediastinitis. While infectious etiologies are frequently identified (Tab.1), the majority of cases remain idiopathic.