Pulmonary hypertension associated with combined fibrosing mediastinitis and bronchial anthracofibrosis: A retrospective analysis in a single Chinese hospital

Xu, Yan; Xu, Weifeng; Liu, Yongjian; Tian, Xinlun; Xu, Ke; Shi, Juhong; Wang, Mengzhao; Cai, Baiqiang; Peng, Min

doi:10.1111/crj.12641

Cited by 6 publications

(2 citation statements)

References 32 publications

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“…FM can be divided into the localized type (localized soft tissue mass, often accompanied by calcification) and diffuse type (diffuse infiltrative mass, no capsule, unclear boundary, generally no cystic change or necrosis) according to the typical manifestations of CT, and the pathological types are granulomatous type and non-granulomatous type ( 8 ). Granulomatous FM is mostly related to tuberculosis, fungi, histoplasmosis infection, or sarcoidosis, while non-granulomatous FM is mostly caused by non-infectious factors, such as autoimmune diseases, drugs, dust, radiation, etc., or it is difficult to identify the cause of the idiopathic disease ( 9 ). This case considered localized FM according to the signs of the contrast-enhanced chest CT. As mentioned above, the causes of FM vary from region to region in the world.…”

Section: Discussionmentioning

confidence: 99%

Endobronchial ultrasound-guided cautery-assisted transbronchial mediastinal cryobiopsy in the diagnosis of fibrosing mediastinitis secondary to atypical sarcoidosis: a case report

Tang,

Tao,

Bao

2024

AME Case Rep

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Background Fibrosing mediastinitis (FM) secondary to atypical sarcoidosis (atypical presentation of sarcoidosis) is rarely reported at home and abroad. Its clinical manifestations represent a lack of specificity, and the initial diagnosis is frequently difficult. In particular, this case has multiple pulmonary nodules with mediastinal lymph node enlargement and bilateral pleural effusion, and pulmonary fibrosis still exists after treatment, which is inconsistent with any clinical stage of pulmonary sarcoidosis, further increasing the diagnostic difficulty. We retrospectively analyzed the clinical data of a case of FM secondary to atypical sarcoidosis diagnosed by endobronchial ultrasound-guided cautery-assisted transbronchial mediastinal cryobiopsy (EBUS-CA-TBMCB) in Chongqing University Fuling Hospital, to improve clinicians’ attention to FM and understand that EBUS-CA-TBMCB remains an effective way of etiological diagnosis. Case Description A 70-year-old man was hospitalized with cough and dyspnea for two months. After admission, through chest computed tomography (CT), ultrasound guided bilateral lung biopsy, left parietal pleural biopsy, and EBUS-CA-TBMCB, the final diagnosis was atypical sarcoidosis secondary FM. After taking glucocorticoid orally, the patient’s condition improved significantly, and was discharged from the hospital. We continued following up outside the hospital, and the patient’s condition was further improved. Conclusions The diagnosis of FM is mainly based on typical imaging manifestations. When the contrast-enhanced chest CT finds localized or diffuse soft tissue density shadows around the mediastinum and pulmonary hilum with an irregular shape, with or without calcification, particular attention should be paid to exclude FM. EBUS-CA-TBMCB, as an improved minimally invasive method, can obtain enough tissue samples for pathological diagnosis, which may be the effective biopsy method for the etiology of FM to avoid missed diagnosis and misdiagnosis in the future.

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Section: Discussionmentioning

confidence: 99%

Endobronchial ultrasound-guided cautery-assisted transbronchial mediastinal cryobiopsy in the diagnosis of fibrosing mediastinitis secondary to atypical sarcoidosis: a case report

Tang,

Tao,

Bao

2024

AME Case Rep

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“…More recently, Xu et al have reported eight patients with PH; attributed to the combination of bronchial anthracofibrosis and fibrosing mediastinitis 9. Interestingly, patients had a combination of bronchial stenoses and elevated PA pressures, evidence of hypoxaemia and PA stenoses.…”

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confidence: 99%