45 year old male, presented with hoarseness of voice followed by difficulty in breathing for 2 months duration. On evaluation he was found to have left vocal cord palsy. CECT chest showed marked thickening of the aorta. No h/o HTN or any major illness. All routine blood parameters are WNL. ANA, RA, Serology, HIV, VDRL negative. On CT angiography showed marked mediastinal and retroperitoneal fibrosis.