Mediastinite esclerosante no diagnóstico diferencial de tumores mediastinais

Abstract

Sclerosing mediastinitis is a rare disorder characterized by an extensive fibrotic reaction involving the mediastinum. Due to the compression or invasion of mediastinal structures, the disorder mimics neoplasia. We present three cases of superior vena cava syndrome in which sclerosing mediastinitis was confirmed. The pathophysiological process is related to enlarged mediastinal lymph nodes, fibroblast proliferation and collagen deposition. The main causes of sclerosing mediastinitis are histoplasmosis and tuberculosis, both of which are prevalent in Brazil. It is difficult to make an accurate histopathological diagnosis using minimally invasive methods, and there is no effective treatment for this condition. In order to make a definitive diagnosis and resolve the aerodigestive tract obstruction, exploratory surgery is indicated.

Bilateral orbital myositis and dacryoadenitis after sclerosing mediastinitis

“…It is usually idiopathic, but it can be related to sarcoidosis, silicosis, trauma, methysergide, histoplasmosis, tuberculosis, actinomycosis, aspergillosis, coccidioidomycosis, zygomycosis, nocardiosis, and lymphatic filiariasis. [6] The diagnosis of sclerosing mediastinitis usually requires surgical biopsy. [6] Steroids, immunosuppressive agents, and tamoxifen have been used to treat sclerosing mediastinitis.…”

“…[6] The diagnosis of sclerosing mediastinitis usually requires surgical biopsy. [6] Steroids, immunosuppressive agents, and tamoxifen have been used to treat sclerosing mediastinitis. [7] Some advocate surgical treatment.…”

“…[7] Some advocate surgical treatment. [6] OIP is typically an IOI and is a diagnosis of exclusion, but can be associated with autoimmune diseases such as Wegener's granulomatosis, rheumatoid arthritis, and systemic lupus erythematosus; syphilis and infectious sinusitis have also been suggested as possible etiologic factors. [8] There are reports that support an immunopathogenic basis for OIP, noting it's link to streptococcal pharyngitis, herpes varicella zoster, and Lyme Disease.…”

Low Cellular Sclerosis of Anterior Mediastinum

“…In the chest X-ray overview in the posteroanterior and lateral projection, as well as in the contrast-enhanced computed tomography of the chest, a paraaortic mass is observed in the anterior upper mediastinum without evidence of compression or deviation of vascular structures. There is no evidence of superior vena cava syndrome which is one of the principal complications [19] of this seldom entity.…”