Mediastinitis pathophysiology: Difference between revisions
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==Overview== | ==Overview== | ||
Mediastinitis is the inflammation or infection of the [[mediastinum]].<ref name="pmid23372962">{{cite journal| author=Koksal D, Bayiz H, Mutluay N, Koyuncu A, Demirag F, Dagli G et al.| title=Fibrosing mediastinitis mimicking bronchogenic carcinoma. | journal=J Thorac Dis | year= 2013 | volume= 5 | issue= 1 | pages= E5-7 | pmid=23372962 | doi=10.3978/j.issn.2072-1439.2012.07.03 | pmc=PMC3548007 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23372962 }} </ref> 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. <ref> 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 </ref> | Mediastinitis is the inflammation or infection of the [[mediastinum]].<ref name="pmid23372962">{{cite journal| author=Koksal D, Bayiz H, Mutluay N, Koyuncu A, Demirag F, Dagli G et al.| title=Fibrosing mediastinitis mimicking bronchogenic carcinoma. | journal=J Thorac Dis | year= 2013 | volume= 5 | issue= 1 | pages= E5-7 | pmid=23372962 | doi=10.3978/j.issn.2072-1439.2012.07.03 | pmc=PMC3548007 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23372962 }} </ref> The anterior and upper regions of the mediastinum are the most often affected.<ref name="pmid17273573">{{cite journal| author=Kang DW, Canzian M, Beyruti R, Jatene FB| title=Sclerosing mediastinitis in the differential diagnosis of mediastinal tumors. | journal=J Bras Pneumol | year= 2006 | volume= 32 | issue= 1 | pages= 78-83 | pmid=17273573 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17273573 }} </ref> 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.<ref> 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 </ref> Additionally, mediastinitis may also present as the result of ''[[Staphylococcus aureus]]'' or ''[[Staphylococcus epidermidis]]'' infection following chest surgery.<ref name="pmid16930768">{{cite journal| author=Konvalinka A, Erret L, Fong IW| title=Impact of treating Staphylococcus aureus nasal carreiers on wound infections in cardiac surgery.| journal=J Hosp Infect| year= 2006 | volume= 64 | issue= 2 | pages= 162-8| pmid= 16930768 | doi= | pmc= |url=http://www.ncbi.nlm.nih.gov/pubmed/16930768 }} </ref> 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== | ==Pathophysiology== | ||
Mediastinitis is the inflammation or infection of the [[mediastinum]].<ref name="pmid23372962">{{cite journal| author=Koksal D, Bayiz H, Mutluay N, Koyuncu A, Demirag F, Dagli G et al.| title=Fibrosing mediastinitis mimicking bronchogenic carcinoma. | journal=J Thorac Dis | year= 2013 | volume= 5 | issue= 1 | pages= E5-7 | pmid=23372962 | doi=10.3978/j.issn.2072-1439.2012.07.03 | pmc=PMC3548007 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23372962 }} </ref> The anterior and upper regions of the mediastinum are the most often affected.<ref name="pmid17273573">{{cite journal| author=Kang DW, Canzian M, Beyruti R, Jatene FB| title=Sclerosing mediastinitis in the differential diagnosis of mediastinal tumors. | journal=J Bras Pneumol | year= 2006 | volume= 32 | issue= 1 | pages= 78-83 | pmid=17273573 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17273573 }} </ref> 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.<ref> 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 </ref> Additionally, mediastinitis may also present as the result of ''[[Staphylococcus aureus]]'' or ''[[Staphylococcus epidermidis]]'' infection following chest surgery.<ref name="pmid16930768">{{cite journal| author=Konvalinka A, Erret L, Fong IW| title=Impact of treating Staphylococcus aureus nasal carreiers on wound infections in cardiac surgery.| journal=J Hosp Infect| year= 2006 | volume= 64 | issue= 2 | pages= 162-8| pmid= 16930768 | doi= | pmc= |url=http://www.ncbi.nlm.nih.gov/pubmed/16930768 }} </ref> | |||
===Gross Pathology=== | ===Gross Pathology=== | ||
On gross pathology, characteristic findings of mediastinitis include:<ref name="pmid11353121">{{cite journal| author=Rossi SE, McAdams HP, Rosado-de-Christenson ML, Franks TJ, Galvin JR| title=Fibrosing mediastinitis. | journal=Radiographics | year= 2001 | volume= 21 | issue= 3 | pages= 737-57 | pmid=11353121 | doi=10.1148/radiographics.21.3.g01ma17737 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11353121 }} </ref><ref name= | On gross pathology, characteristic findings of mediastinitis include:<ref name="pmid11353121">{{cite journal| author=Rossi SE, McAdams HP, Rosado-de-Christenson ML, Franks TJ, Galvin JR| title=Fibrosing mediastinitis. | journal=Radiographics | year= 2001 | volume= 21 | issue= 3 | pages= 737-57 | pmid=11353121 | doi=10.1148/radiographics.21.3.g01ma17737 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11353121 }} </ref><ref name=TPText> Husain A. Thoracic Pathology. Elsevier Health Sciences; 2012.</ref> | ||
*White, fibrotic mass | *White, fibrotic mass | ||
*Distinct gap between [[adipose|adipose tissue]] | *Distinct gap between [[adipose|adipose tissue]] | ||
===Microscopic Pathology=== | ===Microscopic Pathology=== | ||
On microscopic histopathological analysis, characteristic findings of mediastinitis include:<ref name="pmid11353121">{{cite journal| author=Rossi SE, McAdams HP, Rosado-de-Christenson ML, Franks TJ, Galvin JR| title=Fibrosing mediastinitis. | journal=Radiographics | year= 2001 | volume= 21 | issue= 3 | pages= 737-57 | pmid=11353121 | doi=10.1148/radiographics.21.3.g01ma17737 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11353121 }} </ref><ref name= | On microscopic histopathological analysis, characteristic findings of mediastinitis include:<ref name="pmid11353121">{{cite journal| author=Rossi SE, McAdams HP, Rosado-de-Christenson ML, Franks TJ, Galvin JR| title=Fibrosing mediastinitis. | journal=Radiographics | year= 2001 | volume= 21 | issue= 3 | pages= 737-57 | pmid=11353121 | doi=10.1148/radiographics.21.3.g01ma17737 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11353121 }} </ref><ref name=TPText> Husain A. Thoracic Pathology. Elsevier Health Sciences; 2012.</ref> | ||
*Inflammation with granulated tissue | *Inflammation with granulated tissue | ||
*Avascular and paucicellular fibrohyaline tissue | *Avascular and paucicellular fibrohyaline tissue | ||
*Presence of ''[[Staphylococcus aureus]]'', ''[[Staphylococcus epidermidis]]'', or ''[[Histoplasma capsulatum]]'' | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
[[Category:Pulmonology]] | |||
{{WikiDoc Help Menu}} | {{WikiDoc Help Menu}} | ||
{{WikiDoc Sources}} | {{WikiDoc Sources}} | ||
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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.