Follicular dendritic sarcoma masquerading as fibrosing mediastinitis.

Abstract

Fibrosing mediastinitis (FM) is a rare disorder resulting from abnormal immunological-mediated fibro-proliferative reaction in the mediastinum. Here, we describe a case of a 46-year-old female with an incidentally found 11×9 cm posterior mediastinal mass. Multiple biopsies of this unresectable, 18-fluorodeoxyglucose avid mass revealed marked fibrosis without any evidence of malignancy, suggesting idiopathic fibrosing mediastinitis as our initial diagnosis. Multiple interventions including a trial of steroids, fluconazole, and azathioprine to target fibrosing mediastinitis were not successful. Repeat biopsy was consistent with primary mediastinal follicular dendritic cell sarcoma. The manuscript highlights the heightened need for suspecting occult malignancies in cases of FM presenting with an indeterminate cause.

• Authors: Shashank Reddy Cingam, Majd Al Shaarani, Amol Takalkar, Prakash Peddi
• Journal: BMJ case reports (BMJ Case Rep) Vol. 2017 (Jun 13 2017) ISSN: 1757-790X [Electronic] England
• PMID: 28611161 (Publication Type: Case Reports, Journal Article)
• Copyright: © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Topics

• Dendritic Cell Sarcoma, Follicular (diagnosis, diagnostic imaging, drug therapy, pathology)
• Diagnosis, Differential
• Fatal Outcome
• Female
• Humans
• Mediastinitis (diagnosis)
• Mediastinum
• Middle Aged
• Positron Emission Tomography Computed Tomography
• Sclerosis (diagnosis)