Xenon-133 ventilation and Tc-99m MAA perfusion images.
View main image(vq) in a separate image viewer
View second image(xr). PA and lateral chest radiographs.
View third image(ct). Axial CT image in pulmonary windows.
Full history/Diagnosis is available below
CXR: Mild volume loss in the right lung is present. There is minimal increased opacity in the right hilum suggestive of lymphadenopathy. No pneumothorax is seen. The heart size is normal. No pleural effusion identified. Retained contrast is noted in the splenic flexure of the colon.
CT: Narrowed right pulmonary artery as is passes through a soft tissue attenuation mass along the right mediastinum with some calcifications. Mild ground glass attenuation in the right middle lobe.
"Affected patients are typically young and present with signs and symptoms of obstruction or compression of the superior vena cava, pulmonary veins or arteries, central airways, or esophagus. There may be two types of fibrosing mediastinitis: focal and diffuse. The focal type usually manifests on computed tomographic (CT) or magnetic resonance (MR) images as a localized, calcified mass in the paratracheal or subcarinal regions of the mediastinum or in the pulmonary hila. The diffuse type manifests on CT or MR images as a diffusely infiltrating, often noncalcified mass that affects multiple mediastinal compartments. CT and MR imaging play a vital role in the diagnosis and management of fibrosing mediastinitis."
Treatments vary from local excision to antibiotics and steriods depending on patient, symptoms, and suspected etiology.
Rossi, S. E., et al. AFIP Archives: Fibrosing Mediastinitis, Radiographics. 2001;21:737-757.
View followup image(ct). CT pulmonary angiography reconstructed using a Vitrea 2 workstation.
References and General Discussion of Ventilation Perfusion Scintigraphy (Anatomic field:Lung, Mediastinum, and Pleura, Category:Inflammation,Infection)
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