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纤维性纵隔炎所致肺静脉狭窄的介入治疗:一例报告

Interventional treatment for pulmonary venous stenosis due to fibrosing mediastinitis: a case report.

作者信息

Gao Runfeng, Yang Xulong, Sun Shougang, Hu Hao, Yu Yangyang

机构信息

Department of Cardiovascular Medicine, Second Hospital of Lanzhou University, Lanzhou, China.

出版信息

Front Cardiovasc Med. 2025 Aug 14;12:1633432. doi: 10.3389/fcvm.2025.1633432. eCollection 2025.

Abstract

INTRODUCTION

Fibrosing mediastinitis is a rare syndrome caused by the abnormal proliferation of mediastinal fibrous tissue. It often causes superior vena cava syndrome, bronchial stenosis, pulmonary vascular stenosis, etc.

PATIENT PRESENTATION

An elderly male patient presented with intermittent chest tightness, shortness of breath, cough, and large pleural effusion. He was diagnosed with fibrosing mediastinitis through echocardiography, chest CT, and inflammatory indicators. Contrast-enhanced CT and selective angiography showed severe stenosis of multiple branches of bilateral pulmonary veins. The patient is considered to have pulmonary vein stenosis caused by FM, and for further treatment, we performed two interventional therapies at different times. After two operations, the stenosis of bilateral multiple pulmonary veins in this patient has been relieved. Additionally, we also discovered that for pulmonary vein stenosis caused by FM, stent implantation is more effective than balloon dilation.

CONCLUSION

This case report confirmed that interventional treatment for pulmonary vein stenosis is safe and effective. This study also provides a potential treatment approach for pulmonary vein stenosis resulting from fibrosing mediastinitis.

摘要

引言

纤维性纵隔炎是一种由纵隔纤维组织异常增生引起的罕见综合征。它常导致上腔静脉综合征、支气管狭窄、肺血管狭窄等。

患者表现

一名老年男性患者出现间歇性胸闷、气短、咳嗽及大量胸腔积液。通过超声心动图、胸部CT及炎症指标检查,他被诊断为纤维性纵隔炎。增强CT及选择性血管造影显示双侧肺静脉多个分支严重狭窄。该患者被认为患有由纤维性纵隔炎导致的肺静脉狭窄,为进一步治疗,我们在不同时间进行了两次介入治疗。两次手术后,该患者双侧多条肺静脉的狭窄情况得到缓解。此外,我们还发现,对于由纤维性纵隔炎导致的肺静脉狭窄,支架植入比球囊扩张更有效。

结论

本病例报告证实了对肺静脉狭窄进行介入治疗是安全有效的。本研究还为纤维性纵隔炎导致的肺静脉狭窄提供了一种潜在的治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a642/12391052/f7dd767456b5/fcvm-12-1633432-g001.jpg

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