<num>. no evidence of acute disease, including pneumonia or congestive heart failure. <num>. abnormal mediastinal contour including enlarged aorta and increased apparent lobular widening of the right mediastinum. although the technique is different, this appearance raises concern for lymphadenopathy, mass or possibly increasing aortic aneurysm. evaluation with chest ct is recommended when clinically appropriate, preferably with intravenous contrast.