The normal right tracheal stripe is no longer visible. It has been replaced by a soft tissue density with a convex right lateral margin. Additional soft tissue convex margin gives a double contour to the right heart density. The right lateral margin represents a displaced and distorted azygopleural line. Despite the normal sized aortic knuckle, the pleural reflection over the descending aorta is displaced laterally and has a slight convexity. The appearance implies a mediastinal mass that, with several centers of radius, is multifocal or lobulated. The pulmonary vessels are normal size and distribution. The absence of a visible focus of pulmonary consolidation is not unusual in this condition.