fibrosing mediastinitis  

pathogenesis

- pathogenesis of fibrosing mediastinitis

- etiology of fibrosing mediastinitis

pathogenesis of fibrosing mediastinis

 

etiology of fibrosing mediastinitis

- infection

- autoimmune

- others

   

pathology

- gross pathology of fibrosing mediastinitis

- histology of fibrosing mediastinitis

gross pathology of fibrosing medistinitis

 

histology of fibrosing mediastinitis

   

investigation

- lab

- imaging

 

imaging

- CXR

- CT chest

- MRI

- other imaging

- radionuclide studies

- esophagoscopy

imaging

- CXR

- CT chest

- MRI

CXR

- finding in CXR

- imaging of fibrosing mediastinitis

finding in CXR

 

imaging of fibrosing mediastinitis

- diffuse right lung consolidation and some volume loss plus a small right pleural effusion with mild right paratracheal widening with cardiomegaly

CT chest

- finding in CT chest

- imaging of fibrosing mediastinoscopy

finding in CT chest

 

imaging of fibrosing mediastinoscopy

- contrast enhancement at the level of the aortic arch demonstrates right paratracheal lymphadenopathy

- compression of the upper-lobe bronchi bilaterally and resultant atelectasis of upper-lobe segments in both right and left lungs

- more caudal at the level of the pulmonary artery : complete obstruction of the right pulmonary artery with calcified lymph nodes

- more caudal at the level of the left atrium, calcified lymph nodes are also seen occluding the right-middle-lobe bronchus

MRI

- indication MRI

- finding in MRI

indication MRI

- contraindication to use contrast

 

 

finding in MRI

other imaging

- other imaging มีอะไรบ้าง

- imaging in contrast venography

other imaging มีอะไรบ้าง

- contrast esophagography

- pulmonary arteriography

- contrast venography

 

imaging in contrast venography

- the right subclavian and right innominate vein and SVC are obstructed. with extensive collateral channels include the intercostal veins, internal mammary veins, and lateral thoracic branches

esophagoscopy

- indication esophagoscopy

indication esophagoscopy

- dysphagia

   

treatment

- supportive Rx

- surgery

 

supportive Rx

- supportive Rx มีการรักษาอะไรบ้าง

supportive Rx มีการรักษาอะไรบ้าง

- systemic antifungals

- corticosteroid

surgery

- surgery มีทางเลือกรักษาอะไรบ้าง

surgery มีทางเลือกรักษาอะไรบ้าง

- local therapy for complications

** local endoscopic or endovascular therapy

** lser therpay

** balloon dilatation etc.

- surgical resection

** SVC syndrome : bypass surgery

** compressive syndrome : lung resection