Mediastinal Lymph Node Calcification in a Patient with Pulmonary Hypertension: A Novel Clue to Accurate Diagnosis

Abstract

Mediastinal lymph node calcification is an important but often overlooked radiological clue in patients with pulmonary hypertension, particularly in tuberculosis-endemic settings. We report a 27-year-old man with progressive dyspnea and ankle oedema, previously treated successfully for pulmonary tuberculosis, whose echocardiography suggested pulmonary hypertension. Non-contrast chest computed tomography demonstrated extensive, dense, coarse calcification of subcarinal and paratracheal mediastinal lymph nodes, with chronic post-infectious parenchymal lung changes but no evidence of active tuberculosis—consistent with pulmonary hypertension secondary to chronic lung and thoracic sequelae. This case highlights the diagnostic value of careful CT assessment of calcified mediastinal nodes in young patients with pulmonary hypertension.