Presentation
Known cardiac dysfunction, worsening SOB and ankle swelling, any features of pulmonary edema?
Patient Data
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No overt pulmonary edema or focal consolidation / collapse. Normal heart size.
Densely calcified masses in the anterior mediastinum. No evidence on CXR of previous pulmonary TB.
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A later CT confirms the anterior mediastinal, prevascular location of these calcified lymph nodes. Smaller anterior mediastinal and right hilar nodes also demonstated.
Interval evidence of cardiac failure with moderate bilateral pleural effusions.
Case Discussion
The patient had a history of Hodgkin lymphoma as a teenager, treated with radiotherapy. The large calcifed mediastinal nodes are secondary to this treatment.