Imaging of Granulomatous Fibrosing Mediastinitis

Published on Nov 23, 2012in American Journal of Roentgenology3.013
· DOI :10.2214/AJR.11.7319
Michael F. McNeeley9
Estimated H-index: 9
(UW: University of Washington),
Jonathan H. Chung28
Estimated H-index: 28
(University of Colorado Denver)
+ 1 AuthorsJ. David Godwin19
Estimated H-index: 19
(UW: University of Washington)
Sources
Abstract
OBJECTIVE. The purpose of this article is to review and illustrate the pathogenesis, natural history, imaging features, and treatment of granulomatous fibrosing mediastinitis. CONCLUSION. Granulomatous fibrosing mediastinitis is an infiltrative disorder characterized by encasement of the mediastinal viscera; in most cases in the United States, it represents an idiosyncratic immune response to histoplasma. Familiarity with the various imaging features of fibrosing mediastinitis is important for prompt and accurate diagnosis as well as for planning and guiding surgical and less-invasive treatments.
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Background Histoplasmosis may result in a spectrum of complications that require thoracic surgical intervention. We reviewed our 17-year experience in the management of histoplasmosis to determine outcomes as well as gain insight into the distribution of complications requiring surgical intervention. Methods The hospital records of patients who underwent surgical treatment for complications related to histoplasmosis from 1991 to 2008 were reviewed. Based on the predominant presentation, patients...
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Fibrosing mediastinitis is a rare benign condition, which can cause compression of the pulmonary or systemic vessels, tracheobronchial tree, coronary arteries or esophagus, leading to disabling clinical symptoms and even death. The case of a 26-year-old woman who presented with dyspnea is described. She was found to have 80% stenosis of the right pulmonary artery secondary to fibrosing mediastinitis. The stenosis was managed successfully with an endovascular Palmaz-Schatz stent, and the patient ...
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