CTICasesFibrosing mediastinitis
Imaging findings
Chest CT shows a calcified soft tissue mass in the left hilum with extensive infiltrative soft tissue causing complete occlusion of the left pulmonary veins, left pulmonary arteries, and left mainstem bronchus, resulting in a physiologic pneumonectomy and a small left hemithorax with septal thickening.
Key takeaways
Fibrosing mediastinitis is a progressive fibrotic reaction triggered by histoplasmosis antigens. It typically causes severe compression of thin-walled pulmonary vessels, leading to vascular/bronchial occlusion (physiologic pneumonectomy).
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