Clinical Manifestations of Fibrosing Mediastinitis in Chinese Patients

Background: Fibrosing mediastinitis (FM) is a rare disease. FM is thought to be related to prior granulomatous mediastinal infection, such as histoplasmosis or tuberculosis. The majority of cases have been reported in endemic regions for histoplasmosis. The characteristics of cases of FM in China, w...

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Main Authors: Yan Hu, Jian-Xing Qiu, Ji-Ping Liao, Hong Zhang, Zhe Jin, Guang-Fa Wang
Format: Article
Language:English
Published: Wolters Kluwer 2016-01-01
Series:Chinese Medical Journal
Subjects:
Online Access:http://www.cmj.org/article.asp?issn=0366-6999;year=2016;volume=129;issue=22;spage=2697;epage=2702;aulast=Hu
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author Yan Hu
Jian-Xing Qiu
Ji-Ping Liao
Hong Zhang
Zhe Jin
Guang-Fa Wang
author_facet Yan Hu
Jian-Xing Qiu
Ji-Ping Liao
Hong Zhang
Zhe Jin
Guang-Fa Wang
author_sort Yan Hu
collection DOAJ
description Background: Fibrosing mediastinitis (FM) is a rare disease. FM is thought to be related to prior granulomatous mediastinal infection, such as histoplasmosis or tuberculosis. The majority of cases have been reported in endemic regions for histoplasmosis. The characteristics of cases of FM in China, where the prevalence of tuberculosis is high, have not been reported. We analyzed the clinical, imaging, and bronchoscopic features of Chinese patients with FM to promote awareness of this disease. Methods: Between January 2005 and June 2015, twenty patients were diagnosed with FM in our hospital. Medical records and follow-up data were collected. Imaging and biopsy findings were reviewed by radiologists and pathologists. Results: A total of 20 patients were analyzed (8 males and 12 females). The age ranged from 43 to 88 years with a mean age of 69.5 years. Previous or latent tuberculosis was found in 12 cases. Clinical symptoms included dyspnea (18/20), cough (17/20), expectoration (7/20), and recurrent pneumonia (3/20). Chest computed tomography scans showed a diffuse, homogeneous, soft tissue process throughout the mediastinum and hila with compression of bronchial and pulmonary vessels. Calcification was common (15/20). Pulmonary hypertension was present in 9 of 20 cases. Diffuse black pigmentation in the bronchial mucosa was frequently seen on bronchoscopy (12/13). The patients' response to antituberculosis treatment was inconsistent. Conclusions: FM in Chinese patients is most likely associated with tuberculosis. Some characteristics of FM are different from cases caused by histoplasmosis.
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spelling doaj.art-c869b9a895c948cc803fc74bf0e451ee2022-12-22T01:26:46ZengWolters KluwerChinese Medical Journal0366-69992016-01-01129222697270210.4103/0366-6999.193457Clinical Manifestations of Fibrosing Mediastinitis in Chinese PatientsYan HuJian-Xing QiuJi-Ping LiaoHong ZhangZhe JinGuang-Fa WangBackground: Fibrosing mediastinitis (FM) is a rare disease. FM is thought to be related to prior granulomatous mediastinal infection, such as histoplasmosis or tuberculosis. The majority of cases have been reported in endemic regions for histoplasmosis. The characteristics of cases of FM in China, where the prevalence of tuberculosis is high, have not been reported. We analyzed the clinical, imaging, and bronchoscopic features of Chinese patients with FM to promote awareness of this disease. Methods: Between January 2005 and June 2015, twenty patients were diagnosed with FM in our hospital. Medical records and follow-up data were collected. Imaging and biopsy findings were reviewed by radiologists and pathologists. Results: A total of 20 patients were analyzed (8 males and 12 females). The age ranged from 43 to 88 years with a mean age of 69.5 years. Previous or latent tuberculosis was found in 12 cases. Clinical symptoms included dyspnea (18/20), cough (17/20), expectoration (7/20), and recurrent pneumonia (3/20). Chest computed tomography scans showed a diffuse, homogeneous, soft tissue process throughout the mediastinum and hila with compression of bronchial and pulmonary vessels. Calcification was common (15/20). Pulmonary hypertension was present in 9 of 20 cases. Diffuse black pigmentation in the bronchial mucosa was frequently seen on bronchoscopy (12/13). The patients' response to antituberculosis treatment was inconsistent. Conclusions: FM in Chinese patients is most likely associated with tuberculosis. Some characteristics of FM are different from cases caused by histoplasmosis.http://www.cmj.org/article.asp?issn=0366-6999;year=2016;volume=129;issue=22;spage=2697;epage=2702;aulast=HuMediastinitis; Sclerosis; Tuberculosis
spellingShingle Yan Hu
Jian-Xing Qiu
Ji-Ping Liao
Hong Zhang
Zhe Jin
Guang-Fa Wang
Clinical Manifestations of Fibrosing Mediastinitis in Chinese Patients
Chinese Medical Journal
Mediastinitis; Sclerosis; Tuberculosis
title Clinical Manifestations of Fibrosing Mediastinitis in Chinese Patients
title_full Clinical Manifestations of Fibrosing Mediastinitis in Chinese Patients
title_fullStr Clinical Manifestations of Fibrosing Mediastinitis in Chinese Patients
title_full_unstemmed Clinical Manifestations of Fibrosing Mediastinitis in Chinese Patients
title_short Clinical Manifestations of Fibrosing Mediastinitis in Chinese Patients
title_sort clinical manifestations of fibrosing mediastinitis in chinese patients
topic Mediastinitis; Sclerosis; Tuberculosis
url http://www.cmj.org/article.asp?issn=0366-6999;year=2016;volume=129;issue=22;spage=2697;epage=2702;aulast=Hu
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AT hongzhang clinicalmanifestationsoffibrosingmediastinitisinchinesepatients
AT zhejin clinicalmanifestationsoffibrosingmediastinitisinchinesepatients
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