Hemoptysis and Hematemesis Due to a Broncholith: Granulomatous Mediastinitis

Kefri, Maher; Dyke, Sal; Copeland, Scott; Morgan, Calvin; Mehta, Jay B.

doi:10.1097/00007611-199602000-00020

Cited by 10 publications

(3 citation statements)

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“…10,11 Erosion of a fibrotic or calcified mass into an adjacent anatomic structure may result in broncholi- thiasis or hemoptysis. 40 Most patients with mediastinal granuloma are asymptomatic, whereas most patients with fibrosis develop symptoms as the fibrosis encases, narrows, and/or obstructs the anatomical structure. 7,8,10,11,22 In many series, the most common serious complication of granulomatous mediastinitis/mediastinal fibrosis is SVC obstruction 8,10,11 but is uncommon in other reports.…”

Section: Clinical Manifestationsmentioning

confidence: 99%

Mediastinal Granuloma and Mediastinal Fibrosis

Parish¹,

Rosenow²

2002

Seminars in Respiratory and Critical Care Medicine

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Mediastinal granuloma/mediastinal fibrosis is a chronic inflammatory disease of the mediastinum. Mediastinal granuloma is the abnormal enlargment of mediastinal lymph nodes by granulomatous inflammation, is usually asyptomatic or minimally symptomatic, and is often detected on chest radiographs taken for other reasons. In contrast, mediastinal fibrosis is extensive fibrous tissue throughout the middle mediastinum causing compression, encasement, or invasion of the large bronchi, superior vena cava, pulmonary veins, or esophagus, often with serious clinical consequences. Some patients may exhibit a clinical entity characterized by enlarged fibrotic and/or calicified lymph nodes with a variable amount of fibrosis that may be asymptomatic, or may cause symptoms by compression or invasion of structures in the mediastinum. Clinical manifestations may be due to superior vena cava (SVC) obstruction, esophageal compression, large airway involvement, pulmonary artery or pulmonary vein narrowing, or laryngeal or phrenic nerve impingement. Definitive diagnosis is traditionally made on the basis of a surgical exploration and biopsy, either a mediastinoscopy or thoracotomy; however, characteristic findings on computed tomography (CT) of the chest may be sufficient for a diagnosis in a certain number of cases. The best therapy is unknown. Antifungal therapy and corticosteroids have been reported effective in some cases. Surgical resection of localized mediastinal granuloma or fibrosis causing symptoms is often effective. However, surgical resection of extensive mediastinal fibrosis usually is not feasible.

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Section: Clinical Manifestationsmentioning

confidence: 99%

Mediastinal Granuloma and Mediastinal Fibrosis

Parish¹,

Rosenow²

2002

Seminars in Respiratory and Critical Care Medicine

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“…However, high clinical suspicion and early diagnosis with treatment had improved outcome in our patients. Esophageal involvement in GIH can be either due to mediastinal adenitis in which inflamed mediastinal lymph nodes impinge on esophagus causing ulceration and hyperemia or due to fibrosing mediastinitis which is due to exuberant fibrous reaction secondary to H. capsulatum causing compression of various mediastinal structures including esophagus [6]. In our case series 2 patients had esophageal involvement with presence of ulcers in esophagus.…”

mentioning

confidence: 76%

Gastrointestinal histoplasmosis: a case series from a non-endemic region in North India

et al. 2019

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“…Complications of broncholithiasis include fistulous communication between the tracheobronchial tree and esophagus, pleura, or mediastinum. 16,17 Radiologically, broncholiths may be seen on chest x-ray as a calcified nodule or may show features of bronchial obstruction. 18 Computed tomographic findings of an endobronchial or peribronchial calcification are suggestive.…”

Section: Discussionmentioning

confidence: 99%