Chronic Fibrous Mediastinitis Due to Histoplasma Capsulatum (Histoplasmal Mediastinitis)

Lull, George F.; Winn, Dean F.

doi:10.1148/73.3.367

Cited by 17 publications

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“…Additional reports of congenital pulmonary venous stenosis24- 26 A common infectious cause for the pulmonary fibrosis and mediastinitis may exist in our case. Histoplasmosis has been frequently implicated in the past decade9 [31][32][33] and is suggested by the 4+reaction to skin-testing in this patient. Despite the negative complement-fixation studies, negative histological examination, and negative fungus culture, histoplasmosis may be present.34 36 On the other hand, a positive skin test alone is inconclusive evidence.…”

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confidence: 96%

Pulmonary Venous and Arterial Hypertension due to Chronic Fibrous Mediastinitis

1966

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A patient with chronic fibrous mediastinitis presented with bronchial, superior vena caval, and pulmonary venous obstruction, pulmonary hypertension, and pulmonary fibrosis. Pulmonary venous obstruction was confirmed at surgery and explains the hemodynamic findings of elevated pulmonary artery and pulmonary wedge pressures despite low left atrial pressure. Pulmonary function studies showed marked alterations in ventilation-distribution, diffusion, work of breathing, and fixed airway resistance. It is concluded that the pulmonary arterial hypertension was due, in large part, to the pulmonary venous hypertension caused by pulmonary venous obstruction. Unsuccessful surgical intervention has been followed by 10 months of observation during which aldosterone inhibition together with use of chlorothiazide has prevented recurrence of heart failure and pleural effusion. The relationship between the physiological abnormalities and the patient's symptoms is discussed along with the possible relationship between pulmonary venous obstruction and pulmonary fibrosis.

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confidence: 96%