CT Diagnosis of Granulomatous Mediastinitis due to Tuberculosis

Tuberculosis is an important cause of mediastinal granuloma with fibrosing mediastinitis [1,2]. Fibrosing mediastinitis is a chronic process and a late manifestation of mediastinal granuloma. Chronic granulomatous inflammation is characterized by slow progression of fibrosis and fibrocaseous granulomas which develop in the regional mediastinal lymph nodes [2,3]. Plain chest radiograph often confirms the presence of a widened mediastinum but rarely helps in defining the etiology. Cross-sectional imaging of the mediastinum by computed tomography (CT) has become the method of choice for further investigation of a mediastinal abnormality [4]. Magnetic resonance imaging (MRI), on the other hand, can show the vasocompressive effects of fibrosis without the need for intravenous contrast opacification [5]. We report two cases of chronic fibrosing mediastinitis, which is one of the late manifestations of tuberculous infection.