mediastinal fibrosis (fibrosing mediastinitis)

Introduction

An exuberant fibrotic reaction in the mediastinum.

Etiology

• histoplasmosis (most common cause in USA)
• tuberculosis
• autoimmune disease
• pharmaceutical agents
  • methysergide
• idiopathic

Pathology

• delayed hypersensitivity reaction
• most patients do not have active histoplasmosis at the time of diagnosis
• histologic preparations may show non-viable histoplasma organisms
• granuloma formation may be seen
• calcification of hilar & mediastinal lymph nodes may be seen
• calcified tissue may erode into the bronchial lumen causing broncholithiasis
• fibrosis may encircle airways, esophagus & vessels causing compression & occlusion of these structures

More general terms

• fibrosis
• mediastinal disease (diseases of the mediastinum)

Additional terms

• mediastinum