CTICasesFibrosing Mediastinitis causing Pulmonary Venous Obstruction
Imaging findings
CT chest shows a calcified, infiltrative soft tissue mass in the mediastinum causing severe narrowing and occlusion of the pulmonary veins. This has led to localized pulmonary venous congestion, interstitial thickening, septal lines, and pleural effusion, mimicking pulmonary veno-occlusive disease.
Key takeaways
Fibrosing mediastinitis can compress and obstruct the low-pressure pulmonary veins. This produces a pattern of localized pulmonary venous congestion and interstitial edema that mimics left heart failure or PVOD. Recognizing the calcified mediastinal mass is key to the correct diagnosis.
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