Abstract:

This study analyzed the clinical diagnosis and treatment of 2 patients with mediastinal fibrosis (MF) caused by tuberculosis, aiming to enhance the clinicians’ understanding of MF and improve the diagnosis ability of this disease. After multidisciplinary discussions, we found that these 2 patients had certain common characteristics in clinical manifestations, imaging features, bronchoscopy, diagnosis and treatment process. First, due to the chronic course and lack of specificity of clinical symptoms, it was easily misdiagnosed as chronic obstructive pulmonary disease (COPD). Second, imaging examination showed irregular soft tissue shadows in the mediastinum and hilar with calcification, and deformed stenosis of airways and pulmonary vessels. Third, tracheoscopy revealed multiple pigmentation of the mucous membranes, bronchial stenosis or occlusion. Fourth, according to the patient’s previous medical history, anti-tuberculosis irregular treatment history, and positive tuberculosis immunological indicators, it was suggested that MF might be related to tuberculosis infection. Fifth, although poor drug treatment, vascular interventional therapy had certain value for improving clinical symptoms. Thus, tuberculosis infection as a causative factor of MF should be taken seriously, and early detection and treatment are necessary.

Key words: Tuberculosis, Mediastinum, Fibrosis, Diagnosis, Consensus development conferences as topic