Presentation
There was a right hilar mass and multiple mediastinal conglomerated lymph nodes on chest computed tomograp... more A case history is presented of a middle-age patient with a rare cause of haemoptysis presenting as a pulmonary mass associated with mediastinal [scinapse.io]
The disease can either be localised to one or two organs, or be present with diffuse multi-organ disease. Furthermore, lesions in different organs can present simultaneously or metachronously. [mayoclinic.pure.elsevier.com]
[…] by s GP Education Programme 2 Part One Initial presentation 60 year old lady, presents with a 6 week history of right sided chest pain. [healthdocbox.com]
RESULTS: The most common presenting symptom was cough. There were three localized forms and three diffuse forms. Definitive histological diagnosis was most commonly made with mediastinoscopy. [ncbi.nlm.nih.gov]
However, patients may present asymptomatically with an incidental diagnosis. [saudijgastro.com]
Respiratoric
- Chronic Cough
View at Publisher · View at Google Scholar Dimitrios Theofilos, Christina Triantafillidou, Athanasios Zetos, Danai Bisirtzoglou, Froso Konstantinou, Charalampos Marketos, and Georgios Politis, “A 44-Year-Old Man With Chronic Cough, Weakness, and a Mediastinum [hindawi.com]
A 44-Year-Old Man With Chronic Cough, Weakness, and a Mediastinum Mass. CHEST Journal 2015;148:e Inoue M, Nose N, Nishikawa H, Takahashi M, Zen Y, Kawaguchi M. Successful treatment of sclerosing mediastinitis with a high serum IgG4 level. [docplayer.net]
A 44-Year-Old Man With Chronic Cough, Weakness, and a Mediastinum Mass. CHEST Journal 2015;148:e86-90. 58. Inoue M, Nose N, Nishikawa H, Takahashi M, Zen Y, Kawaguchi M. Successful treatment of sclerosing mediastinitis with a high serum IgG4 level. [kipdf.com]
- Sputum
Latent Tuberculosis The dormant form of TUBERCULOSIS where the person shows no obvious symptoms and no sign of the causative agent (Mycobacterium tuberculosis) in the SPUTUM despite being positive for tuberculosis infection skin test. [bioportfolio.com]
Other patients with positive cultures were from bronchoalveolar lavage (6 patients), sputum (4 patients), both bronchoalveolar lavage and sputum (1 patient), and deep tracheal aspiration specimen (1 patient). [aspergillus.org.uk]
Gastrointestinal
- Hematemesis
Downhill esophageal varices is rare, but it sometimes complicates hematemesis. We should keep downhill esophageal varices in mind when we examine a patient with SVC syndrome. [ci.nii.ac.jp]
Cardiovascular
- Jugular Venous Distention
Physical examination revealed jugular venous distention at 90°. [ncbi.nlm.nih.gov]
Musculoskeletal
- Osteoporosis
Updated clinical guidelines for diabetes, lipid disorders, obesity management, osteoporosis, and more, as well as essential treatment updates for the medical management of acromegaly, Cushing's Disease, hypercalcemia, and diabetes mellitus. [books.google.com]
Workup
The authors conclude that the cause of the mass remained idiopathic despite extensive workup. It is worth mentioning that immunoglobulin G4 (IgG4)-related disease was not considered in the differential diagnoses. [onlinejacc.org]
Strock and colleagues that routine measurements of serum IgG4 may add little to the diagnostic workup of patients with FM and that more data regarding the relationship between and FM and IgG4-RD is needed, particularly as rituximab has also been shown [docksci.com]
Workup for invasive mold disease was undertaken in 67%, 73% and 58% (p=0.77) of patients in each risk category, respectively, and antifungal therapy was given to 67%, 54.5%, and 17% (p=0.07). [aspergillus.org.uk]
Imaging workup for IgG4-related disease should include a CT scan of the chest, abdomen and pelvis to detect possible multiorgan involvement, specifics of which will be further described. [rarediseasesjournal.com]
X-Ray
- Mediastinal Mass
The mediastinal mass decreased in size 2 weeks after the initiation of octreotide treatment. After discharge, the patient has received octreotide treatment for 6 months without serious adverse events. [ncbi.nlm.nih.gov]
I recently observed a similar case involving a 78-year-old man with a superior mediastinal mass encasing the left subclavian artery (Figure 1, h through j). [humpath.com]
[…] in the mediastinum that may lead to encasement of mediastinal structures within a dense fibrotic mass. [scinapse.io]
View at Publisher · View at Google Scholar Alexander Zider, and Nader Kamangar, “An 80-Year-Old Woman With Progressive Shortness of Breath and a Mediastinal Mass,” Chest, vol. 150, no. 1, pp. e19–e22, 2016. [hindawi.com]
- Superior Mediastinal Mass
I recently observed a similar case involving a 78-year-old man with a superior mediastinal mass encasing the left subclavian artery (Figure 1, h through j). [humpath.com]
- Anterior Mediastinal Mass
A 54-year-old asymptomatic man presented with an anterior mediastinal mass discovered on chest roentgenogram. Chest computed tomography revealed a noncalcified round mass in the mediastinum. [scinapse.io]
Serum
- Hyperprolactinemia
GWAS of 58 Individuals with Fibrosing Mediastinitis Reveals Possible Underlying Genetic Susceptibility. ( 29043856 ) Richmond B.W....Loyd J.E. 2017 26 Pulmonary Artery Occlusion and Mediastinal Fibrosis in a Patient on Dopamine Agonist Treatment for Hyperprolactinemia [malacards.org]
Treatment
After discharge, the patient has received octreotide treatment for 6 months without serious adverse events. We suggest octreotide as a treatment option for FM. [ncbi.nlm.nih.gov]
TY - JOUR T1 - Successful treatment of sclerosing mediastinitis with a high serum IgG4 level. [unboundmedicine.com]
Both retroperitoneal fibrosis and mediastinal fibrosis responded readily to treatment with steroids. In both cases, mediastinal fibrosis occurred in the absence of autoimmune pancreatitis. [humpath.com]
Successful steroid treatment for fibrosing mediastinitis and sclerosing cervicitis. Ann Thorac Surg 2007;83:1199–201. Albers EL, Pugh ME, Hill KD, Wang L, Loyd JE, Doyle TP. [pulmonarychronicles.com]
Prognosis
Early recognition and diagnosis of IgG4-related FM is essential because a delay in appropriate treatment initiation leads to progressive fibrosis with irreversible organ damage and poor prognosis. [ncbi.nlm.nih.gov]
LESSONS: Early recognition and diagnosis of IgG4-related FM is essential because a delay in appropriate treatment initiation leads to progressive fibrosis with irreversible organ damage and poor prognosis. [nlm.life]
It has a different cause, treatment, and prognosis than acute infectious mediastinitis. Space Infections : Pretracheal space - lies anterior to trachea. Pretracheal space infection leads to mediastinitis. [medbox.iiab.me]
Source: Biomed Res - April 21, 2019 Category: Research Authors: Tags: Biomed Res Int Source Type: research Conclusion Pancreatic metastasis of lung cancer is rare and the prognosis is poor. Chemotherapy can prolong survival significantly. [medworm.com]
Etiology
As IgG4-RD can be treated by glucocorticoids, identification of the etiology of FM by surgical biopsy is essential; however, mediastinal biopsy is often difficult. [ncbi.nlm.nih.gov]
The etiology of sclerosing mediastinitis is varied. Major causes have included infection (Histoplasma capsulatum, other fungi, tuberculosis), sarcoidosis, and trauma and may also be idiopathic. [humpath.com]
Sclerosing mediastinitis is a rare condition thought to result from many etiologies, an abnormal immunologic response to histoplasmosis being the most prominent one in the United States (Table 2). [medical-dictionary.thefreedictionary.com]
The exact etiology of SM is unknown. [saudijgastro.com]
Epidemiology
Further (epidemiological) studies should confirm these preliminary conclusions. [ped-rheum.biomedcentral.com]
Epidemiologic understanding of IgG4-related disease is limited due to insufficient awareness of the diagnosis and its only recent appearance in the medical literature. [rarediseasesjournal.com]
[ edit ] As recognition of IgG4-RD is relatively recent, there are limited studies on its epidemiology. [en.wikipedia.org]
The epidemiology of this disease varies widely ranging from antropophillic, zoophilic, and geophillic dermatophytes, as the main causative agent in different geographic areas, depending on several additional factors. [aspergillus.org.uk]
IgG4-RD is relatively recent, there are limited studies on its epidemiology. [ipfs.io]
Pathophysiology
The pathophysiological process is related to enlarged mediastinal lymph nodes, fibroblast proliferation and collagen deposition. [scinapse.io]
Pathophysiology Mediastinitis is the inflammation or infection of the mediastinum. [1] The anterior and upper regions of the mediastinum are the most often affected. [2] Although the pathogenesis of the infection remains unknown, radiographic, serologic [wikidoc.org]
Pancreatic More information Restrictive Pulmonary Diseases Restrictive Pulmonary Diseases Causes: Acute alveolo-capillary sysfunction Interstitial disease Pleural disorders Chest wall disorders Neuromuscular disease Resistance Pathophysiology Reduced [healthdocbox.com]
Though the underlying pathophysiology is still unclear, untreated disease ultimately leads to irreversible fibrosis. [rarediseasesjournal.com]
Humoral and cell-mediated immunity seem to have roles in the pathophysiology of IgG4-RD, but the details of these roles remain unclear. [nature.com]
Prevention
Others may have compressed blood vessels which can slow or prevent blood flow to and from the heart. The exact cause of fibrosing mediastinitis is not fully understood, but it is not inherited. [rarediseases.info.nih.gov]
[…] sudden cardiac death - guidance (IPG603) Source: National Institute for Health and Care Excellence - NICE - 20 December 2017 Evidence-based recommendations on subcutaneous implantable cardioverter defibrillator insertion for preventing sudden cardiac [evidence.nhs.uk]
Treatment was established to prevent complications due to strictures or compressions. Because of his diabetes, a therapy of low-dose prednisone combined with mycophenolate mofetil, known as steroid sparing agent, was applied. [karger.com]
Spine SBRT is unique due to the requirement of sharp dose falloff to prevent serious neurologic morbidity. With recent advances in radiotherapy planning, robotic patient positionin... [medworm.com]
Although the long-term use of steroids in our patient can be debated, we believe it is safer to maintain our patient on steroids because of failure of other immunosuppressive agents and steroids would prevent relapses. [saudijgastro.com]