On axial CT of the chest at the level of the carina, which structure is immediately anterior to the esophagus and posterior to the trachea?

• A Left atrium
• B Right pulmonary artery
• C Azygos vein
• D Subcarinal lymph nodes (station 7) ✓

Explanation

At the level of the carina, the subcarinal space (station 7 lymph node group) lies in the angle between the right and left main bronchi, anterior to the esophagus. Subcarinal node enlargement displaces the carina and is a key feature visible on both plain radiograph (widening of the carinal angle beyond 70 degrees) and CT. The left atrium lies more caudally and is posterior to the carina. The right pulmonary artery lies anterior to the right main bronchus at this level. The azygos vein arches anteriorly to drain into the SVC and is visible higher up on cross-section.

Reference: BD Chaurasia's Human Anatomy, 8th ed.

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