CTICasesMediastinitis from superinfected calcified histoplasmosis lymph node
Imaging findings
CT shows soft-tissue stranding in the pre-vascular mediastinum and a calcified subcarinal lymph node containing gas, without a drainable fluid collection. Esophagoscopy and bronchoscopy were normal.
Key takeaways
Acute mediastinitis can rarely arise from superinfection of a pre-existing calcified granulomatous lymph node (e.g., histoplasmosis). Gas within a calcified node suggests infection and requires surgical debridement or targeted antibiotic therapy.
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