12 January 2021
: Case report 
Ptosis and Miosis Associated with Fibrosing Mediastinitis
Challenging differential diagnosis, Unusual or unexpected effect of treatment, Rare disease
Shakeel Ahmed1AEF*, Mansoor Hameed12EF, Merlin M. Thomas12EF, Khezar S. Syed1EF, Irfan U. Haq1F, Abbas AlAbbas1DFDOI: 10.12659/AJCR.927556
Am J Case Rep 2021; 22:e927556
Table 1. Fibrosing mediastinitis subtypes and characteristic features.
| Granulomatous (Focal) FM 80–90% of cases (more common) | Nongranulomatous (Diffuse) FM 10–20% of cases (less common) | |
|---|---|---|
| Associated with:SarcoidosisTuberculosisOther Fungal Infections | Associated with:Autoimmune diseases (systemic lupus erythematosus, rheumatoid arthritis, Bechet disease)RadiationIgG4 diseaseDrugs (methysergide) | |
| Cough, dyspnea, hemoptysis, recurrent pneumonia, no extrathoracic symptoms | Cough, dyspnea, recurrent pneumonia, hemoptysis, extrathoracic symptoms possible depending on the other organ systems involved | |
| Focal localized mass in the paratracheal, subcarinal, or hilar region with dense or stippled calcifications | Diffuse infiltrative soft-tissue masses in the mediastinumCalcifications rare | |
| Signs of previous infections like histoplasmosis, e.g. calcified granulomas | Retroperitoneal fibrosis, sclerosing cholangitis, features of other associated autoimmune conditions |