CTICasesLeft Superior Pulmonary Vein Obstruction in Fibrosing Hilaritis
Imaging findings
CT chest shows a dense, calcified hilar soft tissue mass (fibrosing hilaritis) causing severe compression and complete occlusion of the left superior pulmonary vein, associated with dilated bronchial arteries and transpleural systemic venous collaterals.
Key takeaways
Fibrosing mediastinitis/hilaritis can selectively compress and occlude low-pressure pulmonary veins. This leads to chronic localized venous congestion, promoting the development of transpleural systemic venous collaterals (intercostal-to-pulmonary connections) to drain the affected lung.
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