Asymptomatic chest wall Hodgkin disease mimicking fibrosing mediastinitis

Zisis, Charalambos; Kefaloyannis, Emmanuel; Rontogianni, Dimitra; Michalopoulou, Fani; Kalomenidis, Ioannis; Papiris, Spyros; Bellenis, Ion

doi:10.1016/j.jtcvs.2005.09.051

Cited by 7 publications

(5 citation statements)

References 6 publications

(5 reference statements)

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“…Interestingly, the fibrosing mediastinitis recently diagnosed in the patient has also been described preceding a subsequent diagnosis of lymphoma, a complication that has not been detected in our patient during the follow-up [43][44][45].…”

Section: Discussionsupporting

confidence: 69%

Skin Manifestations in Patients with Selective Immunoglobulin E Deficiency

Picado

García-Herrera

Hernández‐Rodríguez

et al. 2022

JCM

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Selective immunoglobulin E deficiency (SIgED) is still an unrecognised primary immunodeficiency despite several observations supporting its existence. This study aimed to describe the skin manifestations associated with SIgED. We retrospectively assessed medical records of patients with SIgED, the diagnosis being based on serum IgE levels ≤2 Uk/L associated with normal serum levels of immunoglobulins G, M, and A. A total of 25 patients (24 female) with SIgED were included in the study. Eleven patients (44%) presented chronic spontaneous urticaria (CSU), five (20%) angioedema always associated with CSU, five erythema (20%), and six eczema (24%). Other, less frequent manifestations were lichen planus, anaphylactoid purpura, thrombocytopenic purpura, bullous pemphigoid, bullous pyoderma gangrenosum, and atypical skin lymphoproliferative infiltrate associated with reactive lymphadenopathy, chronic cholestasis, arthritis, and fibrosing mediastinitis. Fifteen patients (60%) had different types of associated autoimmune diseases, Hashimoto’s thyroiditis being the most frequent (n = 5, 20%), followed by arthritis (n = 4, 16%), autoimmune hepatitis, neutropenia, vitiligo, and Sjögren’s syndrome (n = 2, 8% each). Five malignancies were diagnosed in four patients (16%). An ultralow IgE serum level may be the only biomarker that reveals the presence of a dysregulated immune system in patients with a broad spectrum of skin manifestations.

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Section: Discussionsupporting

confidence: 69%

Skin Manifestations in Patients with Selective Immunoglobulin E Deficiency

Picado

García-Herrera

Hernández‐Rodríguez

et al. 2022

JCM

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“…As in this case, patients with mediastinal ML, who were initially diagnosed pathologically with FM, have been reported, including two cases of nodular sclerotic Hodgkin's lymphoma and a case of anaplastic large cell lymphoma . In each case, multiple biopsies were performed, and finally, a definitive diagnosis was established using immunohistochemistry.…”

Section: Discussionmentioning

confidence: 91%

Mediastinal peripheral T‐cell lymphoma diagnosed by repeated biopsies after an initial diagnosis of fibrosing mediastinitis

Kakuta¹,

Sumitani²,

Sugitani³

et al. 2017

Respirology Case Reports

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We report a case of mediastinal peripheral T‐cell lymphoma not otherwise specified (PTCL‐NOS) diagnosed by repeated biopsies. A 44‐year‐old man was admitted to our hospital with a 2‐week history of facial swelling, neck distension, and dyspnoea on exertion. Computed tomography of the chest showed a mediastinal mass. Initial needle biopsy and video‐assisted thoracoscopic biopsy revealed the pathological diagnosis of fibrosing mediastinitis (FM). Glucocorticoid therapy (prednisolone) was temporarily effective in reducing tumour size. However, other laboratory features suggested that the diagnosis of FM might not be correct. After repeated biopsies, we established the diagnosis of mediastinal PTCL‐NOS. With this correct diagnosis, appropriate therapy for PTCL resulted in the improvement of the clinical manifestations. This report suggests that the presence of malignant lymphoma should be considered in cases of mediastinal tumours, and repeated biopsies may be occasionally needed for consistent diagnosis.

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“…There are only four cases available in the literature that describe idiopathic fibrosing mediastinitis that masqueraded the diagnosis of lymphoma (Table 1). 2,[4][5][6] There are no reports available to support the pathogenesis of lymphoma as a complication of fibrosing mediastinitis. HL may present with dense fibrosis, especially in nodular sclerosis subtype of classic HL, which has been characterized by the presence of collagen band deposition around nodules admixed with neoplastic cells.…”

Section: Clinical Discussionmentioning

confidence: 99%