Abstract
Two cases of granulomatous mediastinitis and two cases of fibrosing mediastinitis were reported.
Both cases of granulomatous mediastinitis were admitted to our hospital complaining of chest pain and dyspnea. Their roentgenograms revealed pleural effusion and a tumor-like shadow in the mediastinum. One was diagnosed by mediastinal biopsy through right parasternal incision, and the other was diagnosed after the removal of the mediastinal mass. Both were diagnosed as granulomatous mediastinitis due to tuberculosis, and they were treated and cured by anti-tuberculosis drugs.
Two cases of fibrosing mediastinitis were admitted with symptoms of superior vena caval obstruction. The chest roentgenograms showed widening of the upper mediastinum. The definitive diagnosis was established by mediastinal biopsy through parasternal incisions. One of them was treated with corticosteroids. The other underwent reconstruction of the superior vena cava. Superior vena caval obstruction symptoms subsided in both cases, and they were discharged.
Mediastinal biopsy through right parasternal incision is a useful method to establish the diagnosis in cases of indeterminate upper mediastinal lesions.
