Transient mediastinal enlargement: An unusual computed tomographic manifestation of pulmonary venous hypertension and congestive heart failure

We describe a case of diffuse superior and middle mediastinal enlargement o f soft tissue attenuation noted on helical computed tomography (CT) of a pa tient with clinical and radiographic findings of congestive heart failure ( CHF), Upon treatment and improvement of his pulmonary venous hypertension, a repeat CT scan revealed resolution of the mediastinal abnormalities. We, therefore, advocate a search for primary CT signs of CHF in patients with f indings of widespread mediastinal distension. If present, repeat CT scannin g after resolution of the cardiac condition should be performed before furt her intervention for the mediastinal abnormality is attempted. Copyright (C ) 2000 S. Karger AG, Basel.