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A Review of Epidemiology, Diagnosis, and Management of Fibrosing Mediastinitis

Abraham O Kuranga

Fibrosing Mediastinitis (FM) is a rare but increasingly recognized complication that has been mainly associated with chronic pulmonary histoplasmosis, granulomatous diseases, infections and autoimmune processes. Symptoms vary depending on compromised structures, mainly structures within the mediastinum. This review will focus on the etiology, clinical presentation and management of fibrosing mediastinitis based on multiple case series published to date. Fibrosing mediastinitis is a rare, mainly associated with histoplasmosis infections. Also associated with sarcoidosis, tuberculosis, malignancies as well as other autoimmune processes. Hallmark features include fibrosing sclerosis encompassing and compromising mediastinal structures, including inferior and superior vena cava, pulmonary artery and vein, esophagus and heart. Treatment approach depends on symptomology, structures involved and include medical management, surgical management and conservative/palliative options. Fibrosing Mediastinitis (FM) is a rare complication that has mainly been associated with histoplasmosis infections, however it can also be a complication of granulomatous infiltrative processes, including tuberculosis and sarcoidosis. The results of this condition can lead to significant symptom burden that require a unique approach to its management. We submit a comprehensive review concerning the natural history and management of fibrosing mediastinitis