A potential role for F-18 FDG PET/CT in evaluation and management of Fibrosing mediastinitis

Louisiana State University in Shreveport, Shreveport, Louisiana, United States
Clinical Nuclear Medicine (Impact Factor: 3.93). 10/2007; 32(9):703-6. DOI: 10.1097/RLU.0b013e318125035b
Source: PubMed


Fibrosing mediastinitis is an uncommon benign disorder, and its pathogenesis and management remain unclear. Conventional imaging techniques (chest radiographs, CT, MRI) may suggest its diagnosis but are frequently nonspecific, and it frequently mimics a malignant process by presenting as a mediastinal mass without calcifications, encasing, and infiltrating adjacent mediastinal structures, and showing an overall aggressive behavior. The value of FDG PET imaging in this entity remains largely unknown with only a few case reports in the literature, and often, biopsy is necessary for definitive diagnosis. We report a case of biopsy proven fibrosing mediastinitis highlighting the utility of PET in the evaluation and management of the disease.

1 Follower
32 Reads
  • [Show abstract] [Hide abstract]
    ABSTRACT: Even tough the ultimate etiologic and pathogenic mechanisms of mediastinal fibrosis are not quite established, several causes have been mentioned as the more frequent inducers, such as histoplasmosis, tuberculosis and other granulomatous diseases. Generally the diagnosis is suggested by a hilar or mediastinal mass, which is seen in thorax radiography, because 40% of patients are asymptomatic. Exeresis of fibrotic Magma is difficult because usually there is no separation with trachea neither with superior cava vein. That is why many times we have to restricted ourselves to the surgical approach on the complications. The present work discusses three new cases of mediastinal fibrosis.
    Revista Clínica Española 05/1993; 192(7):327-8. · 1.06 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: A 62-year-old man with recurrent episodes of coughing underwent a whole-body FDG PET/CT scan to evaluate possible lung malignancy. The PET images showed increased FDG uptake in the right side of the bronchus corresponding to a foreign body on the concurrent CT images. The foreign body was subsequently removed through bronchofiberscopy and was proven to be a fishbone.
    Clinical nuclear medicine 05/2009; 34(4):241-2. DOI:10.1097/RLU.0b013e31819a2037 · 3.93 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Die fibrosierende Mediastinitis oder Mediastinalfibrose ist eine seltene Erkrankung. Sie tritt überwiegend in Verbindung mit einer Histoplasma-capsulatum-Infektion auf. In unseren Breitengraden lässt sich eine spezifische Ursache häufig nicht definieren. Symptome resultieren überwiegend aus der Kompression der zentralen Atemwege und der großen Gefäße wie der V. cava superior oder der Pulmonalarterie. Die pathologisch-histologische Diagnosesicherung erfolgt durch Gewebe aus bronchoskopischen Untersuchungen oder – häufiger – aus chirurgischen Eingriffen wie der Mediastinoskopie. Eine allgemein akzeptierte, wirksame Pharmakotherapie existiert nicht. Üblicherweise wird ein Therapieversuch mit systemischen Kortikosteroiden durchgeführt. Im Management der Erkrankung stehen die interventionellen Maßnahmen wie z.B. Stentimplantationen in Atemwege oder Gefäße im Vordergrund. Mediastinal fibrosis is a rare disease which mostly occurs in combination with Histoplasma capsulatum infections. In European latitudes a specific cause can often not be defined. Symptoms mostly result from compression of the central airways and large vessels such as the superior vena cava or pulmonary artery. The histopathologic diagnosis is made on tissue from bronchoscopic examinations or more commonly from surgical interventions such as mediastinoscopy. A generally accepted effective pharmacotherapy does not exist and therapy is normally attempted with systemic corticosteroids. Interventional measures, such as stent implantation in the airways or vessels, have priority in the management of the disease.
    Der Pneumologe 05/2009; 6(3):161-164. DOI:10.1007/s10405-008-0285-x
Show more