The role of PET scan in monitoring the progression of fibrosing mediastinitis

Kaya, Hatice; Rider, Katherine; Cho, Alexander H.; Schwartz, Arnold M.; Alrehaili, Ghadah; Ahari, Jalil

doi:10.1016/j.clinimag.2015.07.030

Cited by 7 publications

(3 citation statements)

References 15 publications

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“…PET/CT is not routinely used in the evaluation of FM. Authors of a few case studies (34,35) showed variable degrees of FDG avidity, which has been hypothesized to correlate with the extent of inflammatory activity. Furthermore, FDG avidity in an infiltrative mediastinal soft-tissue mass may be a confounding factor for differentiation of FM from malignancy (Figs 7, 8).…”

Section: Imaging Modalities and Features Of Granulomatous And Nongranmentioning

confidence: 99%

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Multimodality Imaging of Focal and Diffuse Fibrosing Mediastinitis

Garrana

Buckley

Rosado-de-Christenson

et al. 2019

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Fibrosing mediastinitis is a rare benign but potentially life-threatening process that occurs because of proliferation of fibrotic tissue in the mediastinum. The focal subtype is more common and typically is associated with an abnormal immunologic response to Histoplasma capsulatum infection. Affected patients are typically young at presentation, but a wide age range has been reported, without a predilection for either sex. The diffuse form may be idiopathic or associated with autoimmunity, usually affects middle-aged and/or elderly patients, and is more common in men. For both subtypes, patients present with signs and symptoms related to obstruction or compression of vital mediastinal structures. The most common presenting signs and symptoms are cough, dyspnea, recurrent pneumonia, hemoptysis, and pleuritic chest pain. Patients with the diffuse subtype may have additional extrathoracic symptoms depending on the other organ systems involved. Because symptom severity is variable, treatment should be individualized with therapies tailored to alleviate compression of the affected mediastinal structures. Characteristic imaging features of fibrosing mediastinitis include infiltrative mediastinal soft tissue (with or without calcification) with compression or obstruction of mediastinal vascular structures and/or the aerodigestive tract. When identified in the appropriate clinical setting, these characteristic features allow the radiologist to suggest the diagnosis of fibrosing mediastinitis. Careful assessment is crucial at initial and follow-up imaging for exclusion of underlying malignancy, assessment of disease progression, identification of complications, and evaluation of treatment response.

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Section: Imaging Modalities and Features Of Granulomatous And Nongranmentioning

confidence: 99%

“…As previously stated, the utility of PET/CT for evaluation of FM has not been studied systematically. Authors of published case reports (34,35) have described variable FDG avidity, which may further confound the diagnosis and be misinterpreted as malignancy.…”

Section: Differential Diagnosismentioning

confidence: 99%

Multimodality Imaging of Focal and Diffuse Fibrosing Mediastinitis

Garrana

Buckley

Rosado-de-Christenson

et al. 2019

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“…Savelli et al used steroid and tamoxifen in combination with good effect initially, and when tamoxifen was stopped disease progression recurred, before regressing once again with combination therapy 32. In contrast, when relapse occurred following weaning doses of steroids as part of combined therapy with tamoxifen in another patient, the team increased steroid doses to induce remission again with good success 29. In another case report, a unique triple combination of itraconazole, tamoxifen and high-dose steroids was successful in reducing FDG activity on PET scanning 28…”

Section: Case Presentationmentioning

confidence: 99%

Post-tuberculous fibrosing mediastinitis: a review of the literature

Jarvis

Howard

et al. 2017

BMJ Open Resp Res

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Fibrosing mediastinitis (FM) is a rare disease where there is thickening of the fibrous tissue in the mediastinum. While histoplasmosis is the the most common recognised cause, the link with tuberculosis (TB) has been rarely documented. We review the link between TB and FM, and describe a case of probable TB-related FM.Our case is of a 74-year-old man who presented with breathlessness 3 years after fully treated TB. Scans revealed a calcified soft tissue mass within the mediastinum, and a diagnosis of fibrosing mediastinitis resulting in pulmonary hypertension was made. Tests for histoplasmosis and IgG4 staining were negative. Surgical intervention was not felt to be beneficial, and he was treated with prednisolone and mycophenolate mofetil.In the review, we highlight the two forms of mediastinitis—granulomatous versus fibrous, and how these two entities may be on a spectrum of disease progression. We also explore the prevalence, clinical presentation, pathogenesis, imaging techniques and treatment options of TB-related FM.

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Die akute und chronische Mediastinitis

Kluge

2016

Chirurg

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After perforation of the esophagus or trachea there is always the risk of an infection of the mediastinum; therefore, the diagnosis is followed by further evaluation and early therapy. The DNM can cause unspecific symptoms of sepsis without an obvious focal point. It is important to be aware of a possible correlation between an oropharyngeal center of infection and mediastinitis in order to initiate appropriate diagnostic imaging in cases with the slightest suspicion. Chronic mediastinitis is a rare condition with varying courses and can be difficult to diagnose. An histological clarification for distinction from malignant diseases appears to be a sensible approach.

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The role of PET scan in monitoring the progression of fibrosing mediastinitis

Cited by 7 publications

References 15 publications

Multimodality Imaging of Focal and Diffuse Fibrosing Mediastinitis

Multimodality Imaging of Focal and Diffuse Fibrosing Mediastinitis

Post-tuberculous fibrosing mediastinitis: a review of the literature

Die akute und chronische Mediastinitis

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