Journal Information
Vol. 11. Issue 2.
Pages 155-163 (March - April 2005)
Share
Share
Download PDF
More article options
Vol. 11. Issue 2.
Pages 155-163 (March - April 2005)
Caso Clínico/Clinical Case
Open Access
Fibrose idiopática do mediastino: A propósito de um caso clínico
Idiophatic mediastinal fibrosis: A case report
Visits
6658
Maria João Canotilho*, Renato Sotto-Mayor**, Encarnação Teixeira***, Alda Manique***, A. Bugalho de Almeida****
* Interna de Pneumologia, Serviço de Pneumologia, Hospital de Santa Maria, Lisboa
** Chefe de Serviço de Pneumologia. Assistente convidado da Faculdade de Medicina de Lisboa, Hospital de Santa Maria, Lisboa
*** Assistente Hospitalar graduada, Serviço de Pneumologia, Hospital de Santa Maria, Lisboa
**** Director de Serviço. Professor Associado da Faculdade de Medicina de Lisboa.
This item has received

Under a Creative Commons license
Article information
Resumo

Descreve-se o caso clínico de um doente do sexo masculino com uma massa mediastínica de crescimento lento. Após terem-se efectuado vários exames complementares, foi através de cirurgia que se confirmou o diagnóstico de fibrose idiopática do mediastino. A remoção parcial da massa permitiu uma estabilização transitória das suas dimensões. Cerca de quatro anos depois, verificou-se um crescimento marcado com repercurssões importantes, através da inevitável compressão de estruturas vitais, que conduziram a hipertensão pulmonar grave. A fibrose idiopática do mediastino é uma entidade extremamente rara, estando descritas associações a outras patologias, mais frequentemente às auto-imunes, mas apresenta sempre um curso fatal quando não é possível a cirurgia.

Rev Port Pneumol 2005; XI (2): 155-163

Palavras-chave:
Fibrose do mediastino
síndroma da veia cava superior
hipertensão pulmonar
mediastinite fibrosante
Abstract

We herein report a case of a male patient, who presented a mediastinal mass that had a slow growth over the years. After surgery, that made the diagnosis of idiopathic mediastinal fibrosis, the growth stabilized. Four years latter it was observed a substantial increase which lead to the inevitable compression of vital structures which, in turn, led to pulmonary hypertension. Idiopathic mediastinal fibrosis is an extremely rare pathology. There are same cases in which it is associated with other pathologies but has always a fatal prognosis when surgery is not an option.

Rev Port Pneumol 2005; XI (2): 155-163

Key words:
Mediastinal fibrosis
superior vena cava syndrome
pulmonary hypertension
fibrosis mediastinites
Full text is only aviable in PDF
Bibliografia
[1.]
M. Herman, M. Sayarlioglu, H. Arslan, H. Ayakta, E. Harman.
Fibrosing mediastinitis and trombosis of superior vena cava associated with Behet disease.
Eur J Radiol, 48 (2003), pp. 209-212
[2.]
A. Trusen, M. Beissert, H. Hebestreit, A. Marx, K. Darge.
Fibrosing mediastinitis with superior vena cava obstruction as initial presentation of Langerhans’ cell histiocytosis in a young child.
Pediatr Radiol, 33 (2003), pp. 485-488
[3.]
O. Sabchez.
Garcia, et al. Les hypertensions artérielles pulmonaires compliquant des maladies systémiques en dehors des cnnectivites.
Presse Med, 32 (2003), pp. 800-803
[4.]
O. Schultz, S. Schhuchmann, G.R. Burmester, F. Buttgereit.
Case number 26: systemic idiophatic fibrosis associated with aortitis.
Ann Rheum Dis, 62 (2003), pp. 486
[5.]
O. Kader, H. Kiralti, O. Oguz, A. Cila, A. Oto, A. Gokoz.
Multifocal fibrosclerosis: a new case report and review of the literature.
Eur J Radiol, 12 (2002), pp. 1134-1138
[6.]
A. Lonzo, J.P. Gomez, A. Vasquez, N. Gonzalez, J. Valtueña.
Fibrosis mediastinica idiopática asociada a hipercoagulabilidad. A propósito de un caso.
An Med Interna, 18 (2001), pp. 638-640
[7.]
M. Harman, M. Sayarlioglu, H. Arslan, H. Ayakta, E. Harman.
Fibrosing mediastinitis and thrombosis of superior vena cava associated with Behcet’s disease.
Eur J Radiol, 48 (2003), pp. 209-212
[8.]
R. Stokes, C. Carpenter, W.D. Dupont, J.E. Loyd.
Mediastinal fibrosis is associated with human leukocyte antigen-A2.
Chest, 117 (2000), pp. 482-485
[9.]
D.B. Flieder, S. Suster, C.A. Moran.
Idiophatic fibroinflamaory (fibrosing/sclerosing) lessions of the mediastinum: a study of 30 cases with emphasis on morphologic heterogeneity.
Mod Pathol, 12 (1999), pp. 257-264
[10.]
M.S. Brooks, J.A. Robinson.
Idiophatic fibrosclerosis.
J Rheumatol, 12 (1985), pp. 575-579
[11.]
I.M. Mitchell, N.R. Saunders, O. Maher, S.C. Lennox, D.R. Walker.
Surgical treatment of idiophatic mediastinal fibrosis: report of five cases.
Thorax, 41 (1986), pp. 210-214
[12.]
S. Kinugasa, S. Tachibana, M. Kawakami, T. Orino, R. Yamamoto, S. Sasaki.
Idiophatic mediastinal fibrosis: report of a case.
Surg Today, 28 (1998), pp. 335-338
[13.]
R. Espinosa, W. Edwards, E. Rosenow, V. Schaff.
Idiophatic pulmonary hilar fibrosis: an unusual cause of pulmonar hypertension.
Mayo Clin Proc, 68 (1993), pp. 778-782
[14.]
I. Aleksic, F. Saldana, T. Busch, D. Basenau, H. Sirbu, A. Schauer, H. Dalichau.
Unsuspeced idiophatic mediastinal fibrosis complicating coronary bypass operation.
Ann Thorac Surg, 67 (1999), pp. 224-225
[15.]
T.P. Dyle, J.E. Loyd, I.M. Robbins.
Percutaneous pulmonary artery and vein stenting: a novel treatment of mediastinal fibrosis.
Am J Respir Crit Care Med, 164 (2001), pp. 657-660
[16.]
A. Fishman, J. Elias, J. Fishman, M. Grippi, L. Kaiser, R. Senior.
3th edition, McGraw-Hill, (1998), pp. 2041-2043
Copyright © 2005. Sociedade Portuguesa de Pneumologia/SPP
Download PDF
Pulmonology
Article options
Tools

Are you a health professional able to prescribe or dispense drugs?