What is the differential diagnosis for this appearance?
That of an anterior mediastinal mass - thymoma, lymphoma, germ cell tumour. Thyroid masses (goitre, cancer) is included in this list but not in this case as the mass is quite a way from the thoracic outlet.
Lobulated right cardiomediastinal contour, confirmed as an anterior mediastinal mass on the lateral projection. Lungs are clear. Cardiac silhouette is not enlarged. No destructive bone lesion.