Mediastinitis pathophysiology
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Anthony Gallo, B.S. [2]
Overview
Mediastinitis is the inflammation or infection of the mediastinum.[1] The anterior and upper regions of the mediastinum are the most often affected.[2] Although the pathogenesis of the infection remains unknown, radiographic, serologic, or histopathologic evidence of prior Histoplasma capsulatum infection, histoplasmosis, or chronic granulomatous disease is always observed.[3] Additionally, mediastinitis may also present as the result of Staphylococcus aureus or Staphylococcus epidermidis infection following chest surgery.[4] On gross pathology, a white, fibrotic mass and a distinct gap with adipose tissue are characteristic findings of mediastinitis. On microscopic histopathological analysis, inflammation with granulated tissue and avascular and paucicellular fibrohyaline tissue are characteristic findings of mediastinitis.
Pathophysiology
Mediastinitis is the inflammation or infection of the mediastinum.[1] The anterior and upper regions of the mediastinum are the most often affected.[2] Although the pathogenesis of the infection remains unknown, radiographic, serologic, or histopathologic evidence of prior Histoplasma capsulatum infection, histoplasmosis, or chronic granulomatous disease is always observed.[5] Additionally, mediastinitis may also present as the result of Staphylococcus aureus or Staphylococcus epidermidis infection following chest surgery.[4]
Gross Pathology
On gross pathology, characteristic findings of mediastinitis include:[6][7]
- White, fibrotic mass
- Distinct gap between adipose tissue
Microscopic Pathology
On microscopic histopathological analysis, characteristic findings of mediastinitis include:[6][7]
- Inflammation with granulated tissue
- Avascular and paucicellular fibrohyaline tissue
- Presence of Staphylococcus aureus, Staphylococcus epidermidis, or Histoplasma capsulatum
References
- ↑ 1.0 1.1 Koksal D, Bayiz H, Mutluay N, Koyuncu A, Demirag F, Dagli G; et al. (2013). "Fibrosing mediastinitis mimicking bronchogenic carcinoma". J Thorac Dis. 5 (1): E5–7. doi:10.3978/j.issn.2072-1439.2012.07.03. PMC 3548007. PMID 23372962.
- ↑ 2.0 2.1 Kang DW, Canzian M, Beyruti R, Jatene FB (2006). "Sclerosing mediastinitis in the differential diagnosis of mediastinal tumors". J Bras Pneumol. 32 (1): 78–83. PMID 17273573.
- ↑ Histopathologic Overlap between Fibrosing Mediastinitis and IgG4-Related Disease. International Journal of Rheumatology (2012). http://www.hindawi.com/journals/ijr/2012/207056/ Accessed on September 25, 2015
- ↑ 4.0 4.1 Konvalinka A, Erret L, Fong IW (2006). "Impact of treating Staphylococcus aureus nasal carreiers on wound infections in cardiac surgery". J Hosp Infect. 64 (2): 162–8. PMID 16930768.
- ↑ Histopathologic Overlap between Fibrosing Mediastinitis and IgG4-Related Disease. International Journal of Rheumatology (2012). http://www.hindawi.com/journals/ijr/2012/207056/ Accessed on September 25, 2015
- ↑ 6.0 6.1 Rossi SE, McAdams HP, Rosado-de-Christenson ML, Franks TJ, Galvin JR (2001). "Fibrosing mediastinitis". Radiographics. 21 (3): 737–57. doi:10.1148/radiographics.21.3.g01ma17737. PMID 11353121.
- ↑ 7.0 7.1 Husain A. Thoracic Pathology. Elsevier Health Sciences; 2012.