Massive Dilatation of the Hemiazygos Vein Secondary to Fibrosing Mediastinitis

Abstract

We describe the imaging findings of a case of fibrosing mediastinitis (FM) that was incidentally diagnosed in a 37-year-old patient complaining of intermittent cough without fever or dyspnea. Her only significant past medical history was a remote history of tuberculosis infection as a child. A chest radiograph showed an abnormal contour of the left paraspinal spine. Contrast-enhanced computed tomography showed an ill-defined soft-tissue mass with small foci of calcifications involving the right paratracheal mediastinum (Figure 1A, white arrows) and causing an occlusion of the left innominate vein, the superior vena cava (Figure 1B, arrow), the azygos vein, and the right main pulmonary artery.