Posterior Mediastinal Mass in a Black Patient With Back Pain

HISTORY  A 32-year-old black African man, living in Spain for the past month, was admitted to our hospital with asthenia, fever, and lower thoracic pain in the back radiating to the epigastrium. The pain was of 2 months' duration. Previous medical history was unremarkable.On admission, physical examination revealed an apparently healthy man with a temperature of 38°C, pulse rate of 94 beats per minute, and blood pressure of 140/70 mm Hg. Except for mild pain on percussion of the thoracic spine, results of physical examination were normal. Neurological examination showed no abnormalities. Laboratory studies revealed an erythrocyte sedimentation rate of 125 mm/h and a mild normochromic, normocytic anemia. In addition, antibodies against human immunodeficiency virus were not demonstrated by both enzyme-linked immunosorbent assay and Western blot testing.A posteroanterior chest film obtained at admission (Fig 1) showed an apparent right hilar mass with sharp margins. It was possible to