Giorgadze Tamar, Koizumi June H, Ronen Shira, Chaump Michael, Magro Cynthia M
Weill Cornell Medical College, Department of Pathology and Laboratory Medicine, 1300 York Ave, New York, NY 10065, United States.
Medical College of Wisconsin, Department of Pathology, 9200 W. Wisconsin Avenue, Milwaukee, WI 53226, United States.
Ann Diagn Pathol. 2017 Apr;27:43-47. doi: 10.1016/j.anndiagpath.2017.01.004. Epub 2017 Jan 19.
Sclerosing mediastinitis (SM) is an aggressive fibroproliferative process in the mediastinum that may lead to encasement of mediastinal structures within a dense fibrotic mass. This disease may cause significant clinical complications, morbidity, and even mortality. The etiology and pathogenesis of SM is unclear and in more than one third of cases remains idiopathic. Among the known causes of SM, granulomatous infection is the commonest. Association of SM with radiation therapy has been rarely reported. Herein, we are reporting a case of postradiation sclerosing mediastinitis diagnosed in fine needle aspiration (FNA) specimen. To our knowledge, this is the first reported case of postradiation sclerosing mediastinitis with unusual striking intracytoplasmic glycogen accumulation. Having high index of suspicion and awareness of the fact that this entity may be also associated with radiation therapy, will be helpful in avoiding diagnostic pitfalls in FNA specimens and guiding proper clinical management.
硬化性纵隔炎（SM）是纵隔内一种侵袭性纤维增生性病变，可导致纵隔结构被包裹在致密的纤维化肿块内。这种疾病可引起严重的临床并发症、发病率甚至死亡率。SM的病因和发病机制尚不清楚，超过三分之一的病例仍为特发性。在已知的SM病因中，肉芽肿性感染最为常见。SM与放射治疗相关的报道很少。在此，我们报告一例在细针穿刺抽吸（FNA）标本中诊断出的放射后硬化性纵隔炎病例。据我们所知，这是首例报道的伴有异常显著胞浆内糖原积聚的放射后硬化性纵隔炎病例。高度怀疑并认识到该实体也可能与放射治疗有关，将有助于避免FNA标本的诊断陷阱并指导正确的临床管理。
