Department of Histopathology, (PGIMER), Sector-12, Chandigarh-160012, India.
Department of Radiodiagnosis, (PGIMER), Sector-12, Chandigarh-160012, India.
Cardiovasc Pathol. 2014 Nov-Dec;23(6):354-7. doi: 10.1016/j.carpath.2014.05.005. Epub 2014 Jun 5.
Fibrosing mediastinitis (FM) is a rare condition characterized by extensive proliferation of fibrous tissue in the mediastinum resulting in mass like lesion. Histoplasma and Mycobacterium tuberculosis are the common infective causes of fibrosing mediastinitis, but Aspergillus infection is an extremely rare cause. Fibrosing mediastinitis due to Aspergillus usually occurs following Aspergillus bronchopneumonia. Cardiac involvement due to Aspergillus-related fibrosing mediastinitis is extremely rare in immune-competent individuals and occurs following some intervention or as a part of disseminated systemic fungal infection. Here, we report two cases of Aspergillus FM with dominant cardiac involvement in immune-competent patients. Both cases presented with large mediastinal mass and large vegetation in the left atrium. Autopsy findings showed the granulomatous Aspergillus mediastinitis and extension into the heart with associated fibrosis. One case was proven to be due to Aspergillus flavus by fungal genomic sequencing. To the best of our knowledge, this is the first report of Aspergillus FM with pancarditis.
纤维性纵隔炎（FM）是一种罕见的疾病，其特征是纵隔内纤维组织广泛增生，导致块状病变。组织胞浆菌和结核分枝杆菌是纤维性纵隔炎的常见感染原因，但曲霉菌感染极为罕见。由曲霉菌引起的纤维性纵隔炎通常发生在曲霉菌支气管肺炎之后。免疫功能正常者因曲霉菌相关纤维性纵隔炎导致的心脏受累极为罕见，通常发生在某些介入治疗后或作为播散性系统性真菌感染的一部分。在这里，我们报告两例免疫功能正常的患者出现以心脏受累为主的曲霉菌 FM。这两例患者均表现为巨大的纵隔肿块和左心房内的大赘生物。尸检结果显示，存在肉芽肿性曲霉菌纵隔炎，并向心脏延伸，伴有纤维化。其中一例通过真菌基因组测序证实为黄曲霉菌引起。据我们所知，这是首例报道的伴有全心炎的曲霉菌 FM。
