Journal Information
Vol. 55. Issue 10.
Pages 533 (October 2019)
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Tracheal Stenosis Due to IgG4-Related Fibrosing Mediastinitis
Estenosis traqueal por mediastinitis fibrosante relacionada con enfermedad por IgG4
Laura Arroyo Parejaa, Ana Triviñoa,
Corresponding author

Corresponding author.
, Carolina Españab
a Servicio de Cirugía Torácica, Hospital Universitario Puerta del Mar, Cádiz, Spain
b Servicio de Neumología, Hospital Universitario Puerta del Mar, Cádiz, Spain
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We report the case of a 62-year-old woman undergoing study for progressive dyspnea. In the chest CT scan, concentric tracheal stenosis was visualized, caused by a right paratracheal mass measuring 5×2cm.

Fiberoptic bronchoscopy revealed 75% stenosis with normal tracheal mucosa. The percutaneous fine needle aspiration performed endoscopically showed respiratory epithelial cells without atypia.

We performed rigid bronchoscopy (RB) to obtain a new biopsy. The histopathological and immunohistochemical studies found tracheal mucosa with fibrosis and lymphoplasmacytic infiltration consistent with IgG4-related fibrosing mediastinitis (FM).

After obtaining the diagnosis, treatment with corticosteroids began. Subsequently, RB was programmed for placement of a Dumon® tracheal stent measuring 18×40mm.

FM is a rare entity that can be classified as idiopathic or secondary. IgG4-related FM has recently been linked to some cases defined until now as idiopathic. This disease must be included in the differential diagnosis of fibrosing mediastinitis1 and mediastinal and tracheal neoplasms, because, as in our patient, these entities can mimic even malignant tracheal disease.

Although treatment can consist of corticosteroids, our patient required placement of a tracheal stent due to critical stenosis of the airway (Fig. 1).

Fig. 1.

(A) Bronchoscopy and CT image of tracheal stenosis. (B) Outcome after treatment with corticosteroids and stenting, after 4 months. (C) Argon plasma coagulation, after biopsy. (D) Placement of Dumon® stent.

S. Takanashi, M. Akiyama, K. Suzuki, K. Otomo, T. Takeuchi.
IgG4-related fibrosing mediastinitis diagnosed with computed tomography-guided percutaneous needle biopsy: two case reports and a review of the literature.
Medicine (Baltimore), 97 (2018), pp. e10935

Please cite this article as: Arroyo Pareja L, Triviño A, España C. Estenosis traqueal por mediastinitis fibrosante relacionada con enfermedad por IgG4. Arch Bronconeumol. 2019;55:533–534.

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