CTICasesPulmonary Vein Stenosis Secondary to Sarcoidosis
Imaging findings
Chest radiograph and CT show advanced stage IV sarcoidosis with progressive massive fibrosis (PMF), hilar retraction, and confluent perihilar soft tissue masses. Contrast-enhanced CT reveals severe narrowing and extrinsic compression of the left superior pulmonary vein and bilateral upper lobe pulmonary veins by the calcified, fibrotic mediastinal and hilar mass. Endovascular stents were successfully deployed in the pulmonary veins to relieve the obstruction.
Key takeaways
Sarcoidosis can cause severe fibrosing mediastinitis-like manifestations, where confluent, calcified hilar-mediastinal mass-like fibrotic tissue compresses adjacent vascular structures. Extrinsic compression of the pulmonary veins or arteries is a rare but serious complication of advanced sarcoidosis that can be successfully treated with endovascular stenting.
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