Fibrosing mediastinitis: An unusual cause of superior vena cava symptoms

Abolfazl Mozafari, Ehsan Choopankareh, Mohammad Chopani, Amir Baharvand, Alireza Gharib

DOI: 10.22122/cdj.v2i1.84

Abstract


Fibrosing mediastinitis is a rare benign disorder caused by the proliferation of acellular collagen and fibrous tissue within the mediastinum. Although many cases are idiopathic, many (and perhaps most) cases are thought to be caused by an abnormal immunologic response to Mycobacterium tuberculosis and Histoplasma capsulatum infections. Collagen formation leads to compression of vital structures, resulting in cough, chest pain, and dyspnea. The following case is a former healthy middle-age man who presented with an 8-year history of cough, chest pain, facial swelling, and trouble breathing, and was subsequently found to have fibrosing mediastinitis. Fibrosing mediastinitis should be considered in the differential diagnosis of cough, chest pain, and dyspnea, primarily when findings such as increased venous pressure are present on physical exam, and hilar abnormalities are seen on chest radiograph.


Keywords


Fibrosing Mediastinitis, Mycobacterium tuberculosis, Superior Vena Cava Syndrome

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References


Loyd JE, Tillman BF, Atkinson JB, Des Prez RM. Mediastinal fibrosis complicating histoplasmosis. Medicine (Baltimore) 1988; 67(5): 295-310.

Osler W. On obliteration of Superior vena cava. The John Hopkins Hospital Bulletin 1903; 14: 169-75.

Doyle TP, Loyd JE, Robbins IM. Percutaneous pulmonary artery and vein stenting: a novel treatment for mediastinal fibrosis. Am J Respir Crit Care Med 2001; 164(4): 657-60.

Hackstein N, Fegbeutel C, Rau WS. Idiopathic mediastinal fibrosis as differential diagnosis of mediastinal structures. Rofo 2004; 176(10): 1510-1.

Light AM. Idiopathic fibrosis of mediastinum: a discussion of three cases and review of the literature. J Clin Pathol 1978; 31(1): 78-88.

Bays S, Rajakaruna C, Sheffield E, Morgan A. Fibrosing mediastinitis as a cause of superior vena cava syndrome. Eur J Cardiothorac Surg 2004; 26(2): 453-5.

Goodwin RA, Nickell JA, Des Prez RM. Mediastinal fibrosis complicating healed primary histoplasmosis and tuberculosis. Medicine (Baltimore) 1972; 51(3): 227-46.

Rossi SE, McAdams HP, Rosado-de-Christenson ML, Franks TJ, Galvin JR. Fibrosing mediastinitis. Radiographics 2001; 21(3): 737-57.

Devaraj A, Griffin N, Nicholson AG, Padley SP. Computed tomography findings in fibrosing mediastinitis. Clin Radiol 2007; 62(8): 781-6.

Rodriguez E, Soler R, Pombo F, Requejo I, Montero C. Fibrosing mediastinitis: CT and MR findings. Clin Radiol 1998; 53(12): 907-10.

Urschel HC, Razzuk MA, Netto GJ, Disiere J, Chung SY. Sclerosing mediastinitis: improved management with histoplasmosis titer and ketoconazole. Ann Thorac Surg 1990; 50(2): 215-21.

Ferguson ME, Cabalka AK, Cetta F, Hagler DJ. Results of intravascular stent placement for fibrosing mediastinitis. Congenit Heart Dis 2010; 5(2): 124-33.


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