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Invasive Aspergillosis of the Mediastinum and Left Hilum: CT Features

Bachir Taouli1,2, Mehdi Cadi1, Véronique Leblond3 and Philippe A. Grenier1

1 Department of Radiology, Hôpital Pitié-Salpêtrière-Assistance Publique-Hôpitaux de Paris, Université Pierre et Marie Curie, 83, Boulevard de l'Hôpital, Paris 75013, France.
2 Present address: Department of Radiology, New York University Medical Center, 560 First Ave., TCH-HW 202, New York NY 10016-6497.
3 Department of Hematology, Hôpital Pitié-Salpêtrière-Assistance Publique-Hôpitaux de Paris, Université Pierre et Marie Curie, Paris 75013, France.



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  		Fig. 1A. —71-year-old man with non-Hodgkin's lymphoma and invasive pulmonary aspergillosis. Posteroanterior chest radiograph shows areas of consolidation in both lungs, predominantly in left lower lobe (arrows).

 


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  		Fig. 1B. —71-year-old man with non-Hodgkin's lymphoma and invasive pulmonary aspergillosis. Transverse contrast-enhanced chest CT scan (mediastinal window settings) obtained at level of left pulmonary artery shows necrotic mediastinal masslike infiltrate invading left pulmonary artery (straight arrows), with thrombus and emphysematous dissection of pulmonary artery wall (curved arrows).

 


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  		Fig. 1C. —71-year-old man with non-Hodgkin's lymphoma and invasive pulmonary aspergillosis. Transverse contrast-enhanced chest CT scan (lung window settings) obtained at same level as B shows alveolar consolidation with surrounding ground-glass opacities (arrows) of left lung and, to lesser extent, of right lung.

 


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  		Fig. 1D. —71-year-old man with non-Hodgkin's lymphoma and invasive pulmonary aspergillosis. Transverse contrast-enhanced chest CT scan (mediastinal window settings) obtained at level of left pulmonary veins shows necrotic mass invading left pulmonary veins and left atrium (arrowhead). Bilateral pleural effusion is present.

 

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