Fibrosing mediastinitis mimicking as chronic pulmonary thromboembolism

Sinha, Dimpi; Kundaragi, Nischal G; Kale, Sudhir; Sharma, Sukrity

doi:10.1259/bjrcr.20190049

Cited by 3 publications

(4 citation statements)

References 14 publications

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“…On the contrast-enhanced chest CT, FM usually shows localized or diffuse soft tissue density shadows in the mediastinum and around the pulmonary hilum, with an irregular shape, with or without calcification, and the most common is to affect the middle mediastinum, while the front and rear mediastinum is rarely affected ( 8 , 13 ). If chest CT shows indirect signs such as exudation, thickened interlobular septum, and thickened bronchovascular bundle, it usually indicates pulmonary interstitial edema after pulmonary vein stenosis ( 8 , 24 ). The imaging findings of this case are consistent with the above literature reports.…”

Section: Discussionmentioning

confidence: 99%

Endobronchial ultrasound-guided cautery-assisted transbronchial mediastinal cryobiopsy in the diagnosis of fibrosing mediastinitis secondary to atypical sarcoidosis: a case report

Tang,

Tao,

Bao

2024

AME Case Rep

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Background Fibrosing mediastinitis (FM) secondary to atypical sarcoidosis (atypical presentation of sarcoidosis) is rarely reported at home and abroad. Its clinical manifestations represent a lack of specificity, and the initial diagnosis is frequently difficult. In particular, this case has multiple pulmonary nodules with mediastinal lymph node enlargement and bilateral pleural effusion, and pulmonary fibrosis still exists after treatment, which is inconsistent with any clinical stage of pulmonary sarcoidosis, further increasing the diagnostic difficulty. We retrospectively analyzed the clinical data of a case of FM secondary to atypical sarcoidosis diagnosed by endobronchial ultrasound-guided cautery-assisted transbronchial mediastinal cryobiopsy (EBUS-CA-TBMCB) in Chongqing University Fuling Hospital, to improve clinicians’ attention to FM and understand that EBUS-CA-TBMCB remains an effective way of etiological diagnosis. Case Description A 70-year-old man was hospitalized with cough and dyspnea for two months. After admission, through chest computed tomography (CT), ultrasound guided bilateral lung biopsy, left parietal pleural biopsy, and EBUS-CA-TBMCB, the final diagnosis was atypical sarcoidosis secondary FM. After taking glucocorticoid orally, the patient’s condition improved significantly, and was discharged from the hospital. We continued following up outside the hospital, and the patient’s condition was further improved. Conclusions The diagnosis of FM is mainly based on typical imaging manifestations. When the contrast-enhanced chest CT finds localized or diffuse soft tissue density shadows around the mediastinum and pulmonary hilum with an irregular shape, with or without calcification, particular attention should be paid to exclude FM. EBUS-CA-TBMCB, as an improved minimally invasive method, can obtain enough tissue samples for pathological diagnosis, which may be the effective biopsy method for the etiology of FM to avoid missed diagnosis and misdiagnosis in the future.

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Section: Discussionmentioning

confidence: 99%

Endobronchial ultrasound-guided cautery-assisted transbronchial mediastinal cryobiopsy in the diagnosis of fibrosing mediastinitis secondary to atypical sarcoidosis: a case report

Tang,

Tao,

Bao

2024

AME Case Rep

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“…Although this pathology can occur at any age [ 2 ], it is generally associated with young adults and affects both sexes in a similar way. The 3 cases we studied involved men with an average age of 33.…”

Section: Discussionmentioning

confidence: 99%

“…Other symptoms include dysphagia with oesophageal invasion, vocal hoarseness due to involvement of the recurrent laryngeal nerve, as well as non-specific chest pain and malaise. Pulmonary artery stenosis or occlusion can lead to pulmonary hypertension, a relatively rare manifestation of fibrosing mediastinitis, as illustrated by the case reported by Sinha and colleagues [ 2 ].…”

Section: Discussionmentioning

confidence: 99%

Post-tuberculosis fibrosing mediastinitis: A report of 3 cases

Bouhamdi,

Boumekrat,

Saddouki

et al. 2024

Radiology Case Reports

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“… [16] Symptomatic patients can also be treated with local therapies directed towards re-establishing patency of occluded airways, pulmonary arteries or vena cava. [17] …”

Section: Discussionmentioning

confidence: 99%

Idiopathic fibrosing mediastinitis

Manyeruke

Perumal

Symons

et al. 2021

Afr J Thorac Crit Care Med

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Fibrosing mediastinitis is rare in settings where histoplasmosis is not endemic. An idiopathic form of the disease may present with indistinguishable features and requires methodical exclusion of competing differential diagnoses. We report the case of a 30-year old female patient who presented with intermittent haemoptysis for the past 2 years with no constitutional symptoms. Computed tomography of the chest revealed a prominent right bronchial arterial circulation with a mass-like lesion, which encased and attenuated the right pulmonary trunk and adjacent structures. Endobronchial ultrasonography with transbronchial fine-needle aspiration showed a paucicellular aspirate with no evidence of malignancy or granulomas. Fungal infection, tuberculosis, sarcoidosis, IgG4-disease, and connective tissue disease were ruled out by appropriate serological, molecular, and microbiological tests. A diagnosis of idiopathic fibrosing mediastinitis was therefore made by exclusion and the patient was successfully treated with oral corticosteroids.

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Fibrosing mediastinitis mimicking as chronic pulmonary thromboembolism

Cited by 3 publications

References 14 publications

Endobronchial ultrasound-guided cautery-assisted transbronchial mediastinal cryobiopsy in the diagnosis of fibrosing mediastinitis secondary to atypical sarcoidosis: a case report

Endobronchial ultrasound-guided cautery-assisted transbronchial mediastinal cryobiopsy in the diagnosis of fibrosing mediastinitis secondary to atypical sarcoidosis: a case report

Post-tuberculosis fibrosing mediastinitis: A report of 3 cases

Idiopathic fibrosing mediastinitis

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