CTICasesMediastinal Lymphangiomatosis
Imaging findings
A young man (early 20s) with dyspnea has large pleural effusions and soft tissue surrounding the aorta and paraspinal region behind the heart that is slightly less attenuating than lymphoma, encasing but not compressing vessels, which pass through it. MRI shows very bright T2 signal with vessels traversing the lesions and slow, progressive late enhancement on post-gadolinium fat-saturated angiographic images. There are associated bone changes, and the process tracks into the chest wall.
Key takeaways
Lymphangiomatosis consists of multiple lymphangiomas that infiltrate the mediastinum and chest wall, encasing rather than compressing vessels, with characteristic very bright T2 signal and slow progressive enhancement. It should not be confused with lymphangioleiomyomatosis, and unlike that entity it can affect young men and involve bone, producing associated osseous changes.
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