RT Journal Article
SR Electronic
T1 Post-tuberculous fibrosing mediastinitis: a review of the literature
JF BMJ Open Respiratory Research
JO BMJ Open Resp Res
FD British Thoracic Society
SP e000174
DO 10.1136/bmjresp-2016-000174
VO 4
IS 1
A1 Zhe Wu
A1 Hannah Jarvis
A1 Luke S Howard
A1 Corrina Wright
A1 Onn Min Kon
YR 2017
UL http://bmjopenrespres.bmj.com/content/4/1/e000174.abstract
AB 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.