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 of soft tissue attenuation noted on helical computed tomography (CT) of a patient 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 findings of widespread mediastinal distension. If present, repeat CT scanning after resolution of the cardiac condition should be performed before further intervention for the mediastinal abnormality is attempted.