Table 2.

Reported causes of graunloma mediastinal mass²²–³¹

	Incidence	Presentations	Complications	Diagnosis / Work-up
Fibrosing granulomatous mediastinitis (as a complication of infectious mediastinal masses)	Rare but incidence is not available Histoplasmosis is the most common cause	2nd – 5th decades with cough, dyspnea, hemoptysis, SVC syndrome, dysphagia, and cor pulmonale	Encasement and obliteration of the tracheobronchial tree, mediastinal vessels and esophagus	Thoracotomy and histopathology are required
Hodgkin's Lymphoma; nodular sclerosing	Nodular sclerosing Hodgkin's has a predilection for the anterior mediastinum A bimodal age distribution More common in middle-aged women	Asymptomatic Cervical or supraclavicular lymphadenopathy, puritus, alcohol intolerance	SVC syndrome and chest wall invasion are uncommon Airway obstruction	Tissue excision Elevated LDH, ESR
Idiopathic (sarcoidosis)	Rare to less than 10%	Hilar adenopathy	Pulmonary fibrosis Increased risk for cancer, in particular lung cancer, malignant lymphomas	Serum ACE elevation in 60%
Infectious causes	The following rare infectious causes: Tuberculosis Syphilis Histoplasmosis Nocardiasis Actinomycosis Blastomycosis Coccidioidomycosis Aspergilliosis	Asymptomatic Cough, dyspnea, pain in the chest, fever, wheezing, dysphagia, and hemoptysis	The most common cause of benign obstruction of the SVC Fibrosing mediastinitis (histoplasmosis is the most common)	Cultures
Wegener's granulomatosis	Middle-aged white 2% among 302 patients in one retrospective study	Upper airway, lungs, and kidney involvement Skin, mucous membranes, eyes, ears, and joints	Sinusitis, tracheal stenosis Relapses Long-term complications (86%): chronic kidney disease, hearing loss and deafness.	Exclude other diagnosis Granulomatous inflammation, geographic necrosis, and vasculitis cANCA, serum creatinine, urine sediment