Table 1 Representative non-neoplastic pathology of the thoracic inlet based on the mnemonic “VINDICATE”
From: Non-neoplastic pathology at the crossroads between neck imaging and cardiothoracic imaging
Category | Examples |
|---|---|
Vascular | Aberrant right subclavian artery, partial anomalous pulmonary venous return (PAPVR), internal jugular venous thrombosis, vasculitis |
Infectious/inflammatory | Lemierre’s syndrome, mediastinitis, esophagitis |
Neurologic | Traction injury of the brachial plexus/brachial plexopathy, perineural cyst/Tarlov cyst, laryngeal nerve injury |
Degenerative | Esophageal diverticulum (Zenker’s, Killian-Jamieson), tracheal diverticulum, musculoskeletal degenerative changes (cervical osteophytosis, diffuse idiopathic skeletal hyperostosis (DISH), disc herniation |
Iatrogenic | Tracheoesophageal fistula, radiation therapy, esophageal tear |
Congenital | Tracheobronchomegaly, dilated thoracic duct, branchial cleft cyst, narrowed thoracic inlet, fibromatosis colli, aberrant right subclavian artery, PAPVR |
Autoimmune | Hashimoto’s thyroiditis, systemic sclerosis causing esophageal dilatation, antiphospholipid syndrome causing thrombosis, thymic hyperplasia |
Traumatic | Blunt or penetrating trauma causing injuries to the esophagus, trachea, vasculature, nerves, muscles, bones, and soft tissues. Examples include pneumomediastinum, sternocleidomastoid muscle hematoma |
Endocrine | Thyroid goiter, parathyroid hyperplasia, Madelung disease |