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Rare disease
CASE REPORT
Follicular dendritic sarcoma masquerading as fibrosing mediastinitis
  1. Shashank Reddy Cingam1,
  2. Majd Al Shaarani2,
  3. Amol Takalkar3,
  4. Prakash Peddi4
  1. 1Department of Internal Medicine, Louisiana State University Health Sciences Center Shreveport, Shreveport, Louisiana, USA
  2. 2Department of Pathology and Translational Pathobiology, Louisiana State University Health Sciences Center Shreveport, Shreveport, Louisiana, USA
  3. 3Center for Molecular Imaging and Therapy, Biomedical Research Foundation of Northwest Louisiana, Shreveport, Louisiana, USA
  4. 4Department of Hematology and Oncology, Lousiana State University Health, Shreveport, Shreveport, Louisiana, USA
  1. Correspondence to Dr Prakash Peddi, ppeddi{at}lsuhsc.edu

Summary

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.

  • Pathology
  • Cardiothoracic surgery
  • Surgical oncology

https://doi.org/10.1136/bcr-2016-218889

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    Footnotes

    • Contributors SRC, MAS, AT contributed to data collection. SRC, PP and MAS are responsible for drafting the article. PP and SRC are responsible for critical revision of the article. All authors have approved the final version.

    • Competing interests None declared.

    • Patient consent Consent obtained from guardian.

    • Provenance and peer review Not commissioned; externally peer reviewed.