Fibrosing mediastinitis with pulmonary hypertension as a complication of pulmonary vein stenosis: A case report and review of the literature

Medicine (Baltimore). 2018 Jan;97(4):e9694. doi: 10.1097/MD.0000000000009694.

Abstract

Introduction: Fibrosingmediastinitis (FM) is caused by a proliferation of fibrous tissue in the mediastinum encasing the mediastinal viscera that results in compression of mediastinal bronchovascular structures. Pulmonary hypertension (PH) is a severe complication of FM caused by extrinsic compression of pulmonary blood vessels.

Case presentation: Here, we present the case of a 47-year-old man who presented with a 10-year history of progressive hemoptysis and a 2-year history of shortness of breath, in whom a diagnosis of FM was made. Occlusion of the superior pulmonary veins was noted, with stenosis of the inferior pulmonary veins, leading to PH. Because the patient was a poor candidate for interventional catheterization, the preferred treatment for FM, his PH has been managed with diuretics, and he remains stable.

Conclusions: FM is a serious, potentially life-threatening condition that is best managed in specialized centers.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Humans
  • Hypertension, Pulmonary / etiology*
  • Male
  • Mediastinitis / etiology*
  • Middle Aged
  • Sclerosis / etiology*
  • Stenosis, Pulmonary Vein / complications*

Supplementary concepts

  • Mediastinal Fibrosis