Öz
Halsizlik ve kilo kaybı şikayetleri ile tetkik edilen 66 yaşındaki erkek hastanın göğüs bilgisayarlı tomografisinde, anterior mediastende, 10 cm boyutlu kitlesel lezyon saptandı. Tanısal amaçlı operasyona alınan hastaya, sol hemitorakstan videotorakoskopik biyopsi uygulandı. Histopatolojik inceleme sonucunda kesin bir tanıya varılamaması üzerine aynı işlem ikinci bir operasyon ile sağ hemitoraksa yönelik uygulandı. Yine tanı elde edilememesi üzerine hasta tekrar operasyona alınarak mediastinotomi uygulandı. Tüm histopatolojik inceleme sonuçları ve klinik bulguları ile birlikte değerlendirilen olguda idiyopatik mediastinal fibrozis tanısına ulaşıldı. (MF) olguları radyolojik olarak malign mediasten tümörleri ile benzerlik gösterebilir ve ayırıcı tanı yapılması büyük önem arz etmektedir.
Anahtar Kelimeler
Kaynakça
- Westerly BD, Johnson GB, Maldonado F, Utz JP, Specks U, Peikert T. Targeting B lymphocytes in progressive fibrosing mediastinitis. Am J Respir Crit Care Med 2014;190(9):1069-71.
- Rossi SE, McAdams HP, Rosado-de-Christenson ML, Franks TJ, Galvin JR. Fibrosing mediastinitis. Radiographics 2001;21(3):737-57.
- Tan R, Nader J, Kamangar N. Tuberculosis-associated fibrosing mediastinitis: Case report and literature review. J Clin Imaging Sci 2016;23(6):32.
- Rossi GM, Emmi G, Corradi D, et al. Idiopathic mediastinal fibrosis: A systemic immune-mediated disorder. A case series and a review of the literature. Clinic Rev Allerg Immunol 2017;52(3):446-59.
- Hu Y, Qiu JX, Liao JP, Zhang H, Jin Z, Wang GF. Clinical manifestations of fibrosing mediastinitis in Chinese patients. Chin Med J 2016;20;129(22):2697-702.
- Gorospe L, Ayala-Carbonero AM, Fernández-Méndez MÁ, et al. Idiopathic fibrosing mediastinitis: Spectrum of imaging findings with emphasis on its association with IgG4-related disease. Clin Imaging 2015;39(6):993-9.
- Sherrick AD, Brown LR, Harms GF, Myers JL. The radiographic findings of fibrosing mediastinitis. Chest 1994;106(2):484-89.
Öz
A 66-year-old male patient who presented with fatigue and weight loss was evaluated by computed tomography and 10 cm mass lesion on the anterior mediastinum was detected. Videothoracoscopy applied to left hemithorax and multiple punch biopsies taken from mediastinal mass. Histopathologic examination of biopsy specimens showed no definite conclusion so the same procedure was applied from the right hemithorax in a second aoperation. A definitive diagnosis was not obtained, so the patient was operated for the third time and this time the mediastinotomy was performed. All these results and the clinical status of the patient were considered and the diagnosis of idiopathic mediastinal fibrosis (IMF) was diagnosed. Mediastinal fibrosis (MF) cases may be similar radiologically to malignant mediastinal tumors. It is important to make a differential diagnosis.
Anahtar Kelimeler
Kaynakça
- Westerly BD, Johnson GB, Maldonado F, Utz JP, Specks U, Peikert T. Targeting B lymphocytes in progressive fibrosing mediastinitis. Am J Respir Crit Care Med 2014;190(9):1069-71.
- Rossi SE, McAdams HP, Rosado-de-Christenson ML, Franks TJ, Galvin JR. Fibrosing mediastinitis. Radiographics 2001;21(3):737-57.
- Tan R, Nader J, Kamangar N. Tuberculosis-associated fibrosing mediastinitis: Case report and literature review. J Clin Imaging Sci 2016;23(6):32.
- Rossi GM, Emmi G, Corradi D, et al. Idiopathic mediastinal fibrosis: A systemic immune-mediated disorder. A case series and a review of the literature. Clinic Rev Allerg Immunol 2017;52(3):446-59.
- Hu Y, Qiu JX, Liao JP, Zhang H, Jin Z, Wang GF. Clinical manifestations of fibrosing mediastinitis in Chinese patients. Chin Med J 2016;20;129(22):2697-702.
- Gorospe L, Ayala-Carbonero AM, Fernández-Méndez MÁ, et al. Idiopathic fibrosing mediastinitis: Spectrum of imaging findings with emphasis on its association with IgG4-related disease. Clin Imaging 2015;39(6):993-9.
- Sherrick AD, Brown LR, Harms GF, Myers JL. The radiographic findings of fibrosing mediastinitis. Chest 1994;106(2):484-89.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Olgu Sunumu |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Haziran 2018 |
| Gönderilme Tarihi | 15 Mart 2017 |
| Yayımlandığı Sayı | Yıl 2018 |