Sclerosing mediastieitis: Improved management with histoplasmosis titer and ketoconazole

Targeting B Lymphocytes in Progressive Fibrosing Mediastinitis

“…Infectious and noninfectious inflammatory triggers have been reported (4). In North America, fibrosing mediastinitis is most commonly associated with histoplasmosis (4,5). Although anecdotal success with antifungal, antiinflammatory, and antifibrotic therapy has been reported (5,6), these results have not been confirmed in larger cases series (4).…”

“…Although anecdotal success with antifungal, antiinflammatory, and antifibrotic therapy has been reported (5,6), these results have not been confirmed in larger cases series (4). Furthermore, the success of surgical and nonsurgical interventions to relieve invasive vascular and airway obstruction has been variable, ranging from complete recovery to therapeutic failure with procedural mortality (4,5,(7)(8)(9)(10). New therapeutic approaches are urgently needed.…”

Fibrosing mediastinitis causing rapidly progressive dyspnea, pulmonary edema and death in a 16 yr old male

“…Systemic antifungal agents, antituberculous treatment and/or corticosteroids have been advocated for treatment if a specific cause is suspected and might assist in stabilisation of the process and/or improvement of symptoms [15]. However, no randomised control trials have been performed to reach solid conclusions.…”

Superior Vena Cava Syndrome Due to Fibrosing Mediastinitis Histologically Identical to Xanthogranulomatous Pyelonephritis.

“…Because the plain radiographic findings of FMare nonspecific and the extent of disease is often underestimated, CT and MRI may be useful and even specific in evaluating this disorder (5). The mainstay of therapy is complete surgical excision of the mass and affected lung (4,6). In some case reports, steroids or antifungal therapies were successfully used for treatment (4,6).…”