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Mediastinitis CT

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Anthony Gallo, B.S. [2]

Overview

Findings on CT scan suggestive of mediastinitis include mediastinal or hilar mass, soft-tissue attenuation, calcifications of the central mass, tracheobronchial narrowing, and pulmonary infiltrates.[1][2][3]

Computed tomography

On CT scan, the appearance of mediastinitis can be variable and dependent on the pattern of involvement. Typically, the disease affects the middle mediastinum and may demonstrate:[1][2][3]

  • Mediastinal or hilar mass
  • Infiltrative region of soft-tissue attenuation which obliterates normal mediastinal fat planes and encases or invades adjacent structures
  • Calcifications of the central mass or associated lymph nodes (especially if there has been preceding histoplasmosis)
  • Tracheobronchial narrowing
  • Pulmonary infiltrates

The following are a collection of radiological findings demonstrating the presence of fibrosing mediastinitis:

  • Axial CT demonstrating airway narrowing of the right lower lobe bronchus. There is thickening of the right pleura and right interlobular septae. There are partially calcified right hilar and mediastinal lymph nodes.[4]
    Axial CT demonstrating airway narrowing of the right lower lobe bronchus. There is thickening of the right pleura and right interlobular septae. There are partially calcified right hilar and mediastinal lymph nodes.[4]
  • Axial CT demonstrating airway narrowing of the right lower lobe bronchus. There is thickening of the right pleura and right interlobular septae. There are partially calcified right hilar and mediastinal lymph nodes.[4]
    Axial CT demonstrating airway narrowing of the right lower lobe bronchus. There is thickening of the right pleura and right interlobular septae. There are partially calcified right hilar and mediastinal lymph nodes.[4]
  • Coronal CT demonstrating airway narrowing of the right lower lobe bronchus. There is thickening of the right pleura and right interlobular septae. There are partially calcified right hilar and mediastinal lymph nodes.[4]
    Coronal CT demonstrating airway narrowing of the right lower lobe bronchus. There is thickening of the right pleura and right interlobular septae. There are partially calcified right hilar and mediastinal lymph nodes.[4]
  • Coronal CT demonstrating airway narrowing of the right lower lobe bronchus. There is thickening of the right pleura and right interlobular septae. There are partially calcified right hilar and mediastinal lymph nodes.[4]
    Coronal CT demonstrating airway narrowing of the right lower lobe bronchus. There is thickening of the right pleura and right interlobular septae. There are partially calcified right hilar and mediastinal lymph nodes.[4]

References

  1. ↑ 1.0 1.1 Fibrosing mediastinitis. Radiopedia.org (2015) http://radiopaedia.org/articles/fibrosing-mediastinitis Accessed on October 2, 2015
  2. ↑ 2.0 2.1 Weinstein JB, Aronberg DJ, Sagel SS (1983). “CT of fibrosing mediastinitis: findings and their utility”. AJR Am J Roentgenol. 141 (2): 247–51. doi:10.2214/ajr.141.2.247. PMID 6603112.
  3. ↑ 3.0 3.1 Marom EM, Goodman PC, McAdams HP (2001). “Focal abnormalities of the trachea and main bronchi”. AJR Am J Roentgenol. 176 (3): 707–11. doi:10.2214/ajr.176.3.1760707. PMID 11222209.
  4. ↑ 4.0 4.1 4.2 4.3 Image courtesy of Dr. Darel E. Heitkamp. Radiopaedia (http://radiopaedia.org/cases/fibrosing-mediastinitis-1 here]). Creative Commons BY-SA-NC


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