BMJ Case Reports 2018; doi:10.1136/bcr-2018-225614
  • Rare disease

Invasive mediastinal aspergillosis presenting as superior vena cava syndrome in an immunocompetent patient

Open Access
  1. Javaid Ahmed Khan1
  1. 1Department of Pulmonology and Critical Care, Aga Khan University Hospital, Karachi, Pakistan
  2. 2Department of Histopathology, Aga Khan University Hospital, Karachi, Pakistan
  1. Correspondence to Dr Yasmin Rahim, yrahim80{at}
  • Accepted 15 August 2018
  • Published 12 September 2018


Invasive aspergillosis (IA) is a disease of the immunocompromised with a predilection for the lungs, although dissemination to all organs is possible. Its diagnosis remains a challenge due to the absence of specific clinical manifestations and laboratory findings. In most cases, diagnosis is eventually made via invasive methods. It carries with it a high mortality due to late diagnosis and delayed treatment. Here, we report a fascinating case of a young, otherwise healthy, immunocompetent patient that presented to us with superior vena cava syndrome and a mediastinal mass. It was anticipated that a malignancy would be found on further workup but, in fact, what was eventually discovered was a case of IA. Our report accentuates the significance of including IA as a differential while diagnosing a mediastinal mass in an immunocompetent host as patient outcome is determined by timely diagnosis and treatment.


  • Contributors The case report was conceptualised by JAK. YR reviewed patient records and examination along with literature research and writing the case report. Histopathology images were provided by AM. The final case report was approved by JAK.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

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

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:

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