Metastatic renal cell carcinoma presenting with mediastinal eggshell calcification.

An 81-year-old South Asian man normally resident in the UK presented with night sweats for over 2 months on a background of weight loss of 4 kg in 6 months. His medical history was significant for metastatic renal cell carcinoma treated 5 years previously with cytoreductive nephrectomy and adjuvant chemotherapy. Following an abnormal chest radiograph showing an ill-defined right paratracheal mass, a CT scan showed eggshell calcification (circumferential calcification) of enlarged low right paratracheal lymph nodes. An endobronchial ultrasound-guided transbronchial needle aspiration of an involved large paratracheal lymph node showed cytology consistent with metastatic renal cell carcinoma.