PNEUMOMEDIASTINUM AND PNEUMOPERICARDIUM DUE TO MALIGNANT SUBCARINAL LYMPHADENOPATHY - CT DEMONSTRATION

A 52-year-man had been treated for oral cancer T3 N0 M0 by radical sur gery, neck dissection on the right and cervical irradiation (60 Gy). T wo months after therapy he presented with dysphagia and hemoptysis. Ad mission chest X-ray revealed a pneumopericardium. It was caused by a b ronchomediastinal fistula due to necrotic metastatic lymph nodes as sh own by CT, which also revealed a concomitant pneumomediastinum. The pa tient died 10 days later from pneumonia. The CT findings were confirme d at autopsy. We conclude that malignant mediastinal lymphadenopathy i s a potential cause of pneumopericardium and pneumomediastinum.