CTICasesLarge Vessel Pulmonary Vasculitis
Imaging findings
CT angiography in a 25-year-old female with inflammatory bowel disease shows progressive narrowing and occlusion of the left pulmonary artery and right middle lobe pulmonary artery over several years. There are prominent bronchial artery collaterals but no venous, lymphatic, or airway obstruction.
Key takeaways
Large-vessel pulmonary vasculitis can selectively involve the pulmonary arteries, mimicking fibrosing mediastinitis. The absence of a soft-tissue mass, lack of venous or airway obstruction, and coexisting inflammatory bowel disease favor a vasculitis over fibrosing mediastinitis.
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