CTICasesFibrosing Mediastinitis from Histoplasmosis
Imaging findings
Perfusion lung scan shows absent perfusion to the right lung. CT angiography demonstrates a dense, calcified subcarinal mediastinal mass obstructing the SVC and right pulmonary veins/arteries, along with collateral paraspinal vessels.
Key takeaways
Fibrosing mediastinitis is a rare, benign, but clinically devastating complication of histoplasmosis characterized by dense fibrosing tissue that calcifies and wraps around mediastinal structures. It can cause complete obstruction of the SVC, pulmonary veins, and pulmonary arteries, leading to pulmonary infarction or heart failure.
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