Fig. 8.

IgG4-related fibrosing mediastinitis. A 60-year-old female with a history of recurrent bilateral pleural effusion in the last 5 years. Clinical history of non-differentiated collagen vascular disease treated with steroids. CT showed marked hypertrophic tissue of the mediastinum and of the pleural space characterised as IgG4 sclerosing disease. A significant hypertrophy of the bronchial arteries (a–c) and intercostal vessels (c) can be observed. The azygos vein diameter is normal before anastomosis with the vena cava, whereas it shows a compression of the lumen in the medio-thoracic tract. Hypodense tissue is seen in the pleural space at the costophrenic angles