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CASE REPORT
Year : 2016  |  Volume : 6  |  Issue : 1  |  Page : 32

Tuberculosis-associated Fibrosing Mediastinitis: Case Report and Literature Review


1 Department of Medicine, Olive View - UCLA Medical Center, Los Angeles, California, USA
2 Department of Medicine, Olive View - UCLA Medical Center, Los Angeles, California; Division of Pulmonary and Critical Care Medicine, Olive View - UCLA Medical Center, Los Angeles, California, USA

Correspondence Address:
Nader Kamangar
Department of Medicine, Division of Pulmonary and Critical Care Medicine, Olive View - UCLA Medical Center, David Geffen School of Medicine at UCLA, 14445 Olive View Drive, Room 2B-182, Sylmar, CA 91342
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2156-7514.188958

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Fibrosing mediastinitis is a rare condition defined by the presence of fibrotic mediastinal infiltrates that obliterate normal fat planes. It is a late complication of a previous granulomatous infection, such as histoplasmosis or tuberculosis (TB). Due to its rarity, fibrosing mediastinitis is often under-recognized, and the clinical presentation is variable and dependent on the extent of infiltration or encasement of structures within the mediastinum. We present a case of fibrosing mediastinitis in a man with a prior history of TB, who presented with progressive dyspnea and was found to have chronic mediastinal soft tissue opacities and pulmonary hypertension. His diagnosis was delayed due to the lack of recognition of this clinical/radiographic entity. Fibrosing mediastinitis is a rare entity usually caused by granulomatous disease. Most cases develop as a late complication of histoplasmosis or TB. The presence of calcified mediastinal soft tissue infiltrates on advanced chest imaging can be diagnostic of fibrosing mediastinitis in patients with a prior history of a granulomatous infection once active processes such as malignancy are excluded.


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