Wilmer J A, de Vries R A, Meijer J W, Richter C
Afd. Klinische Geriatrie, Ziekenhuis Rijnstate, Arnhem.
Ned Tijdschr Geneeskd. 2004 Mar 13;148(11):530-3.
A 47-year-old woman was examined due to fever of unknown origin. She had been on holiday in Southeast Asia. Routine laboratory investigations confirmed the presence of inflammation. Serology for Hepatitis B virus, HIV, Borrelia, Cytomegalovirus, toxoplasmosis, lues, Epstein Barr virus, brucellosis, bartonellosis, histoplasmosis and auto-immune factors was negative. CT-scans of the chest and abdomen failed to reveal the cause. Finally, gallium-67 scintigraphy showed an increased uptake in the left mediastinum and the left side of the neck. This led to the discovery of an infraclavicular mass. On histological examination of the surgical excision biopsy the diagnosis 'fibrosing mediastinitis' was made. The patient was treated successfully with corticosteroids.
一名47岁女性因不明原因发热接受检查。她曾在东南亚度假。常规实验室检查证实存在炎症。乙肝病毒、艾滋病毒、疏螺旋体、巨细胞病毒、弓形虫病、梅毒、爱泼斯坦-巴尔病毒、布鲁氏菌病、巴尔通体病、组织胞浆菌病及自身免疫因子的血清学检查均为阴性。胸部和腹部的CT扫描未发现病因。最后,镓-67闪烁扫描显示左纵隔和颈部左侧摄取增加。这导致发现了一个锁骨下肿块。手术切除活检的组织学检查诊断为“纤维性纵隔炎”。患者接受皮质类固醇治疗成功。