CTICasesFibrosing Mediastinitis Infiltrating the Left Pulmonary Artery
Imaging findings
CT chest shows a calcified, infiltrative soft tissue mass in the left hilum causing complete occlusion of the left main pulmonary artery and the left superior pulmonary vein, resulting in left lung volume loss and secondary perfusion anomalies.
Key takeaways
Fibrosing mediastinitis is a chronic fibroinflammatory disease typically triggered by Histoplasma capsulatum. While it usually causes extrinsic compression of mediastinal vessels, it can directly infiltrate and destroy vessel walls, mimicking chronic thromboembolic disease (CTEPH) or pulmonary sarcoma, and represents an inoperable, high-risk surgical lesion.
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