Effective glucocorticoid treatment in a case of idiopathic fibrosing mediastinitis].

Go Kato, Koichiro Takahashi, Tomonori Abe, Chiho Kakino, Ayako Matsuo, Naomi Kobayashi, Kazutoshi Komiya, Naoko Sueoka-Aragane, Shinichiro Hayashi

Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University.

Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society 2011 Nov

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A 54-year-old man was admitted to Saga University hospital with dyspnea on effort and a sensation of pressure in the chest. Chest CT images showed a low-density mass in the mediastinum surrounding the carina and left hilus, causing narrowing of both the left pulmonary artery and left main bronchus. The pathological findings from a surgical biopsy showed markedly fibrotic tissue with lymphocytes and plasmacytes, and we diagnosed idiopathic fibrosing mediastinitis, stage II. Oral glucocorticoid treatment of 30 mg/day prednisolone reduced the mass and improved the narrowing of the left pulmonary artery and left main bronchus. The patient was given low-dosage glucocorticoids as maintenance treatment. Previous reports indicated that idiopathic fibrosing mediastinitis with severe tissue fibrosis is difficult to control with glucocorticoid monotherapy. Here, we report a case of idiopathic fibrosing mediastinitis that was effectively treated with glucocorticoids.

Citation

Go Kato, Koichiro Takahashi, Tomonori Abe, Chiho Kakino, Ayako Matsuo, Naomi Kobayashi, Kazutoshi Komiya, Naoko Sueoka-Aragane, Shinichiro Hayashi. Effective glucocorticoid treatment in a case of idiopathic fibrosing mediastinitis]. Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society. 2011 Nov;49(11):822-6