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Granulomatous Disease

  • Nicola Martucci
  • Giuseppe De Luca
  • Gaetano Rocco
Chapter
Part of the Current Clinical Pathology book series (CCPATH)

Abstract

Granulomatous disease of the mediastinum is a particular pathological condition characterized by the formation of granulomas in mediastinal lymph nodes. Mediastinal granuloma is the abnormal enlargement of mediastinal lymph nodes by granulomatous inflammation, is usually asymptomatic or minimally symptomatic, and is often detected on chest radiographs taken for other reasons.

Clinical manifestations may be due to superior vena cava (SVC) obstruction, esophageal compression, large airway involvement, pulmonary artery or pulmonary vein narrowing, or laryngeal or phrenic nerve impingement. Definitive diagnosis is traditionally made on the basis of a cytological exam or surgical exploration and biopsy, either a mediastinoscopy or thoracotomy.

Keywords

Mediastinal granuloma Mediastinal granulomatosis 

References

  1. 1.
    James DG. A clinicopathological classification of granulomatous disorders. Postgrad Med J. 2000;76(898):457–65. Review.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Mukhopadhyay S, Gal AA. Granulomatous lung disease: an approach to the differential diagnosis. Arch Pathol Lab Med. 2010;134(5):667–90.PubMedGoogle Scholar
  3. 3.
    Parish JM, Rosenow EC 3rd. Mediastinal granuloma and mediastinal fibrosis. Semin Respir Crit Care Med. 2002;23(2):135–43.CrossRefPubMedGoogle Scholar
  4. 4.
    Asano S. Granulomatous lymphadenitis. J Clin Exp Hematop. 2012;52(1):1–16.CrossRefPubMedGoogle Scholar
  5. 5.
    James DG, Neville E. Pathobiology of sarcoidosis. Pathobiol Annu. 1977;7:31–61.PubMedGoogle Scholar
  6. 6.
    Webb WR. The mediastinum: mediastinal masses. In: Webb WR, Higgins CB, editors. Thoracic imaging: pulmonary and cardiothoracic radiology. 2nd ed. Philadelphia: Lippincott Williams & Wilkins; 2011. p. 219–85.Google Scholar
  7. 7.
    King TE Jr. Sarcoidosis: interstitial lung diseases: Merck Manual Home Edition. The Merck Manual Home Edition. Merck Sharp & Dohme Corp. Retrieved 19 Feb 2014.Google Scholar
  8. 8.
    Dempsey OJ, Paterson EW, Kerr KM, Denison AR. Sarcoidosis. BMJ. 2009;339:b3206.CrossRefPubMedGoogle Scholar
  9. 9.
    Pearson Griffith S, et al. Thoracic surgery. 2002, New York, Churchill Livingstone Inc. ed. 2nd ed.Google Scholar
  10. 10.
    Nag S. Sarcoid-like reactions, sarcoidosis diagnosis and management, Prof. Mohammad Hosein Kalantar Motamedi (Ed.). InTech; 2011. http://www.intechopen.com/books/sarcoidosis-diagnosis-and-management/sarcoid-like-reactions.
  11. 11.
    Hegde S, Rithesh KB, Baroudi K, Umar D. Tuberculous lymphadenitis: early diagnosis and intervention. J Int Oral Health. 2014;6(6):96–8.PubMedPubMedCentralGoogle Scholar
  12. 12.
    Wang WC, Chen JY, Chen YK, Lin LM. Tuberculosis of the head and neck: a review of 20 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;107(3):381–6.CrossRefPubMedGoogle Scholar
  13. 13.
    Sahin F, Yildiz P. Mediastinal tuberculous lymphadenitis presenting as a mediastinal mass with dysphagia: a case report. Iran J Radiol. 2011;8(2):107–11.PubMedPubMedCentralGoogle Scholar
  14. 14.
    Karagöz T, Şenol T, Bekçi TT. Tuberculous lymphadenitis. Turk Thoracic J. 2001;1:74–9.Google Scholar
  15. 15.
    Pirina P, Spada V, Santoru L, Polo MF, Molicotti P, Marras V, Cossu Rocca P, Canu S, Zanetti S, Fois AG. Chest tuberculosis with mediastinal asymptomatic lymphadenitis without lung involvement in an immunocompetent patient. J Infect Dev Ctries. 2013;7(3):280–5.CrossRefPubMedGoogle Scholar
  16. 16.
    Lee KS, Song KS, Lim TH, Kim PN, Lee BH. Adult-onset pulmonary tuberculosis: findings on chest radiographs and CT scans. AJR. 1993;160:753–8.CrossRefPubMedGoogle Scholar
  17. 17.
    Powell DA. Lymphadenitis in tuberculosis. In: Schlossber D, editor. Tuberculosis and non-tuberculous mycobacterial infections. New York: Springer; 1994. p. 113–20.Google Scholar
  18. 18.
    Iyengar KB, Kudru CU, Nagiri SK, Rao ACK. Tuberculous mediastinal lymphadenopathy in an adult. BMJ Case Rep. 2014. Jan 13. 2014.Google Scholar
  19. 19.
    Baran R, Tor M, Tahaoğlu K, et al. Intrathoracic tuberculous lymphadenopathy: clinical and bronchoscopic features in 17 adults without parenchymal lesions. Thorax. 1996;51:87–9.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Ayed AK, Behbehani NA. Diagnosis and treatment of isolated tuberculous mediastinal lymphadenopathy in adults. Eur J Surg. 2001;167:334–8.CrossRefPubMedGoogle Scholar
  21. 21.
    Lieberman J, Nosal A, Schlessner A, et al. Serum angiotensin-converting enzyme for diagnosis and therapeutic evaluation of sarcoidosis. Am Rev Respir Dis. 1979;120:329–35.PubMedGoogle Scholar
  22. 22.
    Dines DE, Payne WS, Bernatz PE, Pairolero PC. Mediastinal granuloma and fibrosing mediastinitis. Chest. 1979;75:320–4.CrossRefPubMedGoogle Scholar
  23. 23.
    Novella Sánchez L, Sanz Herrero F, Berraondo Fraile J, Fernández Fabrellas E. Mediastinal fibrosis and superior vena cava syndrome. Arch Bronconeumol. 2013;49(8):340–2.CrossRefPubMedGoogle Scholar
  24. 24.
    Mathisen DJ, Grillo HC. Clinical manifestation of mediastinal fibrosis and histoplasmosis. Ann Thorac Surg. 1992;54:1053–8.CrossRefPubMedGoogle Scholar
  25. 25.
    James ED, Harris SS, Dillenberg CJ, et al. Tracheal stenosis: an unusual presenting complication of idiopathic fibrosing mediastinitis. J Thorac Cardiovasc Surg. 1980;80:410–3.PubMedGoogle Scholar
  26. 26.
    Espinosa RE, Edwards WD, Rosenow EC III, Schaff HV. Idiopathic pulmonary hilar fibrosis: an unusual cause of pulmonary hypertension. Mayo Clin Proc. 1993;68:778–82.CrossRefPubMedGoogle Scholar
  27. 27.
    McNeeley MF, Chung JH, Bhalla S, Godwin JD. Imaging of granulomatous fibrosing mediastinitis. AJR. 2012;199(2):319–27.CrossRefPubMedGoogle Scholar
  28. 28.
    Evison M, Crosbie PAJ, Morris J, Martin J, Barber PV, Booton R. A study of patients with isolated mediastinal and hilar lymphadenopathy undergoing EBUS-TBNA. BMJ Open Respir Res. 2014;1(1):e000040.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Nicola Martucci
    • 1
  • Giuseppe De Luca
    • 1
  • Gaetano Rocco
    • 1
  1. 1.Division of Thoracic Surgery, Thoracic DepartmentIstituto Nazionale Tumori, IRCCS, Fondazione PascaleNaplesItaly

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