Respir Case Rep. 2021; 10(2): 114-118 | DOI: 10.5505/respircase.2021.24654

A Case of Fibrosing Mediastinitis Mimicking Malignant Mass Lesion with Tracheal Involvement, Diagnosed by Video-assisted Mediastinoscopy

Seher Susam¹, Berna Eren Komurcuoglu², Kenan Can Ceylan³, Nur Yücel^4
1Departmant of Radiology, Health Sciences University Dr. Suat Seren Chest Disease and Thoracic Surgery Training and Research Hospital, Ýzmir, Turkey
²Departmant of Chest Disease, Health Sciences University Dr. Suat Seren Chest Disease and Thoracic Surgery Training and Research Hospital, Ýzmir, Turkey
³Departmant of Thoracic Surgery, Health Sciences University Dr. Suat Seren Chest Disease and Thoracic Surgery Training and Research Hospital, Ýzmir, Turkey
⁴Departmant of Pathology, Health Sciences University Dr. Suat Seren Chest Disease and Thoracic Surgery Training and Research Hospital, Ýzmir, Turkey

A 27-year-old female patient was admitted with a complaint of cough and dyspnea, and was found to have a mediastinal mass lesion and tracheal stenosis on computed tomography. Other system examinations were usual. The transbronchial biopsy result was benign cytology. Magnetic resonance imaging (MRI) revealed no compression or invasion into vascular structures. The lesion was noted to be hypermetabolic in positron emission tomography (PRT) imaging. No benign or malignant differentiation could be based on the imaging findings. Due to a tracheal stricture, the patient underwent video-assisted mediastinoscopy for diagnosis and for the determination of a treatment approach. The procedure was successfully terminated upon the arrival of a frozen biopsy result with non-caseified fibrosing mediastinitis. The case is presented as a rare non-tumoral mediastinal disease that mimics malignancy and that was difficult to diagnose based on imaging findings.

Keywords: Mediastinitis, fibrosis, computed tomography, magnetic resonant imaging, medias-tinoscopy.

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Trakeal Tutulum ile Malign Kitle Lezyonunu Taklit Eden ve Video Yardýmlý Mediastinoskopi ile Taný Alan Fibrozan Mediastinit Olgusu

Seher Susam¹, Berna Eren Komurcuoglu², Kenan Can Ceylan³, Nur Yücel^4
1Saðlýk Bilimleri Üniversitesi, Dr Suat Seren Göðüs Hastalýklarý ve Cerrahisi Eðitim ve Araþtýrma Hastanesi, Radyoloji Bölümü, Ýzmir
²Saðlýk Bilimleri Üniversitesi, Dr Suat Seren Göðüs Hastalýklarý ve Cerrahisi Eðitim ve Araþtýrma Hastanesi, Göðüs Hastalýklarý Bölümü, Ýzmir
³Saðlýk Bilimleri Üniversitesi, Dr Suat Seren Göðüs Hastalýklarý ve Cerrahisi Eðitim ve Araþtýrma Hastanesi, Göðüs Cerrahisi Bölümü, Ýzmir
⁴Saðlýk Bilimleri Üniversitesi, Dr Suat Seren Göðüs Hastalýklarý ve Cerrahisi Eðitim ve Araþtýrma Hastanesi, Patoloji Bölümü, Ýzmir

Öksürük ve dispne þikayeti ile baþvuran 27 yaþýndaki kadýn hastanýn, akciðer grafisi ve bilgisayarlý tomografi tetkikinde, trakeal stenoz oluþturan mediastinal kitle lezyonu saptandý. Diðer sistem muayeneleri normal idi. Transbronþial biyopsi sonucu ise benign olarak geldi. Manyetik rezonans görüntülemede vasküler yapýlara basý ya da invazyon saptanmadý. Pozitron Emisyon Tomografisi ile görüntülemede lezyon hipermetabolik idi. Kitle lezyonunda görüntüleme bulgularý ile benign ya da malign ayýrýmý yapýlamadý. Trakeal striktür nedeniyle, taný ve tedavi amacýyla olguya video yardýmlý mediastinoskopi yapýldý, frozen biyopsi sonucunun non-kazeifiye fibrozan mediastinit gelmesi üzerine iþlem baþarý ile sonlandýrýldý. Maligniteyi taklit eden, görüntüleme bulgularý ile tanýsý zor nontümöral nadir mediastinal bir hastalýk olmasý nedeniyle olgu sunulmuþtur.

Anahtar Kelimeler: Mediastinit, fibrozis, bilgisayarlý tomografi, manyetik rezonans görüntüleme, mediasti-noskopi.

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