pseudoaneurysm of the aortic arch with concealed rupture with cardiac temponade

An approximately 2.6 x 1.7 cm intensely contrast opacified outpouching arising from the left lateral wall of anterior part of aortic arch protruding into the anterior mediastinum with surrounding layered soft tissue/fluid collection ( 40 HU ) – suggestive of pseudoaneurysm of the aortic arch with concealed rupture.

Small bilateral pleural effusions (right more than left) associated with encysted right pericardial effusion measuring 2.4 cm in maximum thickness (5 to 20 HU).

This encysted pericardial effusion is causing mild extrinsic compression of right ventricle, right atrium with dilated IVC and SVC – suggesting cardiac tamponade

Subpleural multifocal atelectasis involving left upper lobe, lingula and left lower lobe associated with small streaky scarring with minimal traction bronchiectasis – ‘chronic tuberculous cicatrization’.

Tiny nodular airspace opacities scattered randomly in the left upper lobe – suggestive of active pulmonary tuberculosis.