Aggressive and progressive fibrosing mediastinitis involving the thoracic spine mimicking malignancy: A case report.

Published on Feb 12, 2019in Radiology Case Reports
· DOI :10.1016/J.RADCR.2019.02.003
Hee Kang (Kosin University Gospel Hospital), Min Jung Jung (Kosin University Gospel Hospital)
Abstract Fibrosing mediastinitis is an uncommon benign disorder in which a chronic inflammatory reaction results in diffuse fibrosis of the mediastinum, potentially compromising the airways, great vessels and other mediastinal structures. Herein we describe a progressive course of fibrosing mediastinitis in a 72-year-old man. Computed tomography images depicted a diffuse, infiltrative, soft tissue mass involving the esophagus and superior vena cava in the mediastinum. Magnetic resonance imaging revealed destruction of the adjacent thoracic spine. Positron emission tomography-computed tomography also revealed increased metabolism in the periphery of the mass.
#1Luis Gorospe (Hospital Universitario de Canarias)H-Index: 1
#1Luis GorospeH-Index: 6
Last. Eva Mañas-BaenaH-Index: 1
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Abstract Purpose The purpose of this study was to review the clinicoradiological features of idiopathic fibrosing mediastinitis (FM). Methods The records of six patients with idiopathic FM were retrospectively reviewed. Results The most common presenting symptom was cough. There were three localized forms and three diffuse forms. Definitive histological diagnosis was most commonly made with mediastinoscopy. Interestingly, three of our patients had disease manifestations of IgG4-related disease (...
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#1Michael F. McNeeley (UW: University of Washington)H-Index: 9
#2Jonathan H. Chung (University of Colorado Denver)H-Index: 28
Last. J. David Godwin (UW: University of Washington)H-Index: 19
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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 p...
32 CitationsSource
#1Saumitra Kant (University of Texas MD Anderson Cancer Center)H-Index: 1
#2Garrett L. WalshH-Index: 62
Fibrosing mediastinitis is a rare, chronic inflammatory disease that has several implicated etiologies. We describe a case of a 41-year old woman who presented with the classic signs and symptoms of superior vena cava syndrome. Imaging revealed a diffuse infiltrative mediastinal process, which on biopsy was consistent with fibrosing mediastintis.
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#1Tobias Peikert (Mayo Clinic)H-Index: 29
#2Bijayee Shrestha (Mayo Clinic)H-Index: 3
Last. Eunhee S. Yi (Mayo Clinic)H-Index: 47
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Fibrosing mediastinitis (FM) and IgG4-related disease (IgG4-RD) are two fibroinflammatory disorders with potentially overlapping clinical and radiological features. In this paper, we looked for histopathologic features of IgG4-RD and enumerated infiltrating IgG4-positive plasma cells within mediastinal tissue biopsies from FM patients. We identified 15 consecutive FM surgical mediastinal tissue biopsies between 1985 and 2006. All patients satisfied the clinical and radiological diagnostic criter...
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#2Allison K. CabalkaH-Index: 30
Last. Donald J. Hagler (Mayo Clinic)H-Index: 72
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Objective. Fibrosing mediastinitis is a rare disorder characterized by an excessive fibrotic reaction in the mediastinum which can result in compromise of mediastinal structures. We sought to evaluate short- and midterm results of intravascular thoracic vessel stent placement for patients with fibrosing mediastinitis. Design. We reviewed all records of fibrosing mediastinitis patients who were referred for stent placement to treat mediastinal vascular compression over a 7-year period. Catheteriz...
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#1Amol TakalkarH-Index: 11
#2Gabriel L. BrunoH-Index: 2
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Abstract: Fibrosing mediastinitis is an uncommon benign disorder, and its pathogenesis and management remain unclear. Conventional imaging techniques (chest radiographs, CT, MRI) may suggest its diagnosis but are frequently nonspecific, and it frequently mimics a malignant process by presenting as a mediastinal mass without calcifications, encasing, and infiltrating adjacent mediastinal structures, and showing an overall aggressive behavior. The value of FDG PET imaging in this entity remains la...
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#1Kyung-Yung Lee (Konkuk University)H-Index: 9
#2J G YiH-Index: 1
Last. Jin Sung KimH-Index: 15
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To our knowledge, no report exists of a posterior mediastinal thin band-like mass as a manifestation of fibrosing mediastinitis. A man showed right pleural effusion on chest radiograph. On CT, there was a band-like mass on thoracic prevertebral area. MRI demonstrated the enhancing longitudinal band-like mass all along the vertebrae on coronal and sagittal scans. It was hypermetabolic on PET–CT and there was another hot mass in the presacral area. Additional pelvic MRI showed presacral mass with ...
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#1Semin Chong (SKKU: Sungkyunkwan University)H-Index: 1
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#1Simon Bays (BRI: Bristol Royal Infirmary)H-Index: 3
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Fibrosing mediastinitis is a rare, chronic inflammatory process that can cause superior vena cava syndrome, and can mimic malignancy. We present two cases of this disease where surgical resection was not possible and review the treatment options. q 2004 Elsevier B.V. All rights reserved.
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#1Muhammad Imran (Tohoku University)H-Index: 74
#2Kazuo KubotaH-Index: 43
Last. Masatoshi ItohH-Index: 45
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Whole-body serial positron emission tomography scanning was done using fluorine-18 fluorodeoxygluclose (F-18 FDG) in a patient with a mediastinal mass. Uptake correlated well with the clinical symptoms and aggressiveness of the disease. Based on the F-18 FDG findings, a biopsy specimen was taken from the active region of the mass, which confirmed the diagnosis of sclerosing mediastinitis.
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