CTICasesFibrosing Mediastinitis
Imaging findings
Chest CT demonstrates calcified mediastinal lymphadenopathy and infiltrative, calcified soft tissue thickening surrounding the central airways, pulmonary arteries, pulmonary veins, and the aorta, which shows compression and remodeling. The pulmonary venous compression has resulted in ipsilateral pulmonary venous congestion and interstitial edema. Calcified granulomas are also seen in the lower mediastinum.
Key takeaways
Fibrosing mediastinitis is a rare, benign, but clinically devastating condition characterized by proliferation of dense fibrous tissue in the mediastinum, typically triggered by an abnormal immunological response to a prior granulomatous infection (such as Histoplasma capsulatum or Tuberculosis). It often leads to severe compromise of low-pressure mediastinal structures, such as the pulmonary veins and superior vena cava, resulting in localized pulmonary venous congestion or SVC syndrome.
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