Mediastinal Fibrosis of the Pulmonary Artery Secondary to Tuberculosis.
Mediastinal fibrosis is an uncommon disease involving the esophagus, respiratory tract, and great vessels. We report a man who presented with dyspnea on exertion. Computed tomography of the chest demonstrated granulomatous disease with dense calcifications leading to severe stenosis of the main pulmonary artery (PA) and narrowing of the superior vena cava. The results of tuberculosis (TB) interferon-γ release assay and TB-polymerase chain reaction were positive for Mycobacterium tuberculosis. The patient received 2 weeks of treatment for latent TB before undergoing resection of fibrotic tissue and replacement of the main and branch PAs using a homograft.
Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland. Electronic address: oojeifo2@jhmi.edu.
Oluseyi
O
Ojeifo
Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Nisha A
NA
Gilotra
Division of Cardiothoracic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Clinton D
CD
Kemp
Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Andrew
A
Leventhal
Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Jon
J
Resar
Division of Cardiothoracic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Kenton J
KJ
Zehr
Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Steve
S
Jones
D001157:Arterial Occlusive Diseases / Q000382:microbiology*; D005355:Fibrosis / Q000382:microbiology; D006801:Humans; D008297:Male; D008482:Mediastinum / Q000473:pathology*; D008875:Middle Aged; D011651:Pulmonary Artery; D014397:Tuberculosis, Pulmonary / Q000150:complications*