Chest CT Appearances

Fibrosing Mediastinitis CT Findings

• Mediastinal widening
• Infiltrative soft tissue
• Enlarged lymph nodes
• Tracheal narrowing
• Narrowing of the bronchi
• Can encase the pulmonary arteries
• Granulomatous (“focal”):
  • Focal, localized mass
  • Dense calcification
  • Encapsulated
• Non-granulomatous (“diffuse”):
  • Diffuse infiltration
  • Does not calcify
  • Less common

Other Information About Fibrosing Mediastinitis

Etiology:

• Prior exposure to histoplasmosis
• May be idiopathic

Epidemiology:

• Rare
• Typically presents in the 3rd-4th decade of life
• More common in females

Presentation:

• Cough
• Chest pain
• Dyspnea
• Facial swelling (SVC syndrome)

Prognosis:

• Fibrosing mediastinitis is benign

Related Pearls: Mediastinal Masses

Related Lectures:
CT of the Chest with a Focus on the Mediastinum: Interesting Cases and What We Can Learn From Them - Part 2
CT of the Esophagus: Pearls and Pitfalls in the ER - Part 2