| Autor: |
Mitrovic-Jovanovic, Milica, Skrobic, Ognjan, Odalovic, Strahinja, Djikic Rom, Aleksandra, Plavsic, Aleksandra, Jankovic, Aleksandra, Kostadinovic, Milena, Ivanovic, Nenad, Simic, Aleksandar, Djuric-Stefanovic, Aleksandra, Kovac, Jelena Djokic |
| Zdroj: |
Journal of International Medical Research; December 2023, Vol. 51 Issue: 12 |
| Abstrakt: |
Idiopathic mediastinal fibrosis, also called sclerosing or fibrosing mediastinitis, is a very rare and aggressive fibroinflammatory process characterized by fibrous tissue proliferation in the mediastinal region. Herein, we present a rare case of idiopathic mediastinal fibrosis presenting with esophageal obstruction, most likely associated with immunoglobulin G (IgG4)-related disease, affecting the posterior mediastinum with intrapulmonary infiltration. Computed tomography revealed a narrowed lumen and thickened wall of the distal esophagus surrounded by a necrotic mass with infiltration into the nearby structures, suggesting a locally advanced malignant process. Positron emission tomography revealed intense accumulation of 18F-fluorodeoxyglucose, indicating an active inflammatory component, which complicates further differential diagnosis of mediastinal masses. Thoracoscopic biopsy and immunohistochemical analysis confirmed a fibroinflammatory process with perivascular lymphoid cell infiltration that was cluster of differentiation (CD)3 (++) and CD20 (++), with massive numbers of IgG4-immunoreactive plasma cells. Although a benign condition, sclerosing mediastinitis is a close mimicker of esophageal carcinoma, which cannot be differentiated by computed tomography or positron emission tomography and must be considered in a differential diagnosis. |
| Databáze: |
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