Abstract
Idiopathic pulmonary hilar fibrosis is a condition related to mediastinal fibrosis, characterized by localization of the fibrosing process to one or both pulmonary hila. This results in pulmonary hypertension and bronchial narrowing. Three patients suffering from this disease, in whom the diagnosis has been confirmed by thoracotomy, are reported. The clinical and pathological features are described and previously reported cases are reviewed. The syndrome is classified into two types, according to whether the obstruction affects mainly the pulmonary artery or veins. The disease is a self-limiting one but may lead to organic changes in the lungs causing severe disability.
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- ANDREWS E. C., Jr Five cases of an undescribed form of pulmonary interstitial fibrosis caused by obstruction of the pulmonary veins. Bull Johns Hopkins Hosp. 1957 Jan;100(1):28–42. [PubMed] [Google Scholar]
- BARRETT N. R. Idiopathic mediastinal fibrosis. Br J Surg. 1958 Nov;46(197):207–218. doi: 10.1002/bjs.18004619703. [DOI] [PubMed] [Google Scholar]
- BARTHOLOMEW L. G., CAIN J. C., WOOLNER L. B., UTZ D. C., FERRIS D. O. Sclerosing cholangitis: its possible association with Riedel's struma and fibrous retroperitonitis. Report of two cases. N Engl J Med. 1963 Jul 4;269:8–12. doi: 10.1056/NEJM196307042690102. [DOI] [PubMed] [Google Scholar]
- BINDELGLASS I. L., TRUBOWITZ S. Pulmonary vein obstruction: an uncommon sequel to chronic fibrous mediastinitis. Ann Intern Med. 1958 Apr;48(4):876–891. doi: 10.7326/0003-4819-48-4-876. [DOI] [PubMed] [Google Scholar]
- BRADFIELD E. O. Bilateral ureteral obstruction due to envelopment and compression by an inflammatory retroperitoneal process. J Urol. 1953 Jun;69(6):769–773. doi: 10.1016/S0022-5347(17)68146-1. [DOI] [PubMed] [Google Scholar]
- BREWER D. B., HUMPHREYS D. R. Primary pulmonary hypertension with obstructive venous lesions. Br Heart J. 1960 Jun;22:445–448. doi: 10.1136/hrt.22.3.445. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Botticelli J. T., Schlueter D. P., Lange R. L. Pulmonary venous and arterial hypertension due to chronic fibrous mediastinitis. Hemodynamics and pulmonary function. Circulation. 1966 Jun;33(6):862–871. doi: 10.1161/01.cir.33.6.862. [DOI] [PubMed] [Google Scholar]
- Brown C. H., Harrison C. V. Pulmonary veno-occlusive disease. Lancet. 1966 Jul 9;2(7454):61–65. doi: 10.1016/s0140-6736(66)91801-0. [DOI] [PubMed] [Google Scholar]
- Buckberg G. D., Longmire W. P., Jr, Dilley R. B. The protean manifestations of sclerosing fibrosis. Surg Gynecol Obstet. 1966 Oct;123(4):729–736. [PubMed] [Google Scholar]
- Cameron D. G., Ing S. T., Boyle M., Mathews W. H. Idiopathic Mediastinal and Retroperitoneal Fibrosis. Can Med Assoc J. 1961 Jul 29;85(5):227–232. [PMC free article] [PubMed] [Google Scholar]
- Cheris D. N., Dadey J. L. Fibrosing mediastinitis. An unusual cause for cor pulmonale. Am J Roentgenol Radium Ther Nucl Med. 1967 Jun;100(2):328–331. [PubMed] [Google Scholar]
- Comings D. E., Skubi K. B., Van Eyes J., Motulsky A. G. Familial multifocal fibrosclerosis. Findings suggesting that retroperitoneal fibrosis, mediastinal fibrosis, sclerosing cholangitis, Riedel's thyroiditis, and pseudotumor of the orbit may be different manifestations of a single disease. Ann Intern Med. 1967 May;66(5):884–892. doi: 10.7326/0003-4819-66-5-884. [DOI] [PubMed] [Google Scholar]
- Dozois R. R., Bernatz P. E., Woolner L. B., Andersen H. A. Sclerosing mediastinitis involving major bronchi. Mayo Clin Proc. 1968 Aug;43(8):557–569. [PubMed] [Google Scholar]
- EDWARDS J. E., BURCHELL H. B. Multilobar pulmonary venous obstruction with pulmonary hypertension; protective arterial lesions in the involved lobes. AMA Arch Intern Med. 1951 Mar;87(3):372–378. doi: 10.1001/archinte.1951.03810030045004. [DOI] [PubMed] [Google Scholar]
- ELDER J. C., BROFMAN B. L., KOHN P. M., CHARMS B. L. Unilateral pulmonary artery absence or hypoplasia; radiographic and cardiopulmonary studies in five patients. Circulation. 1958 Apr;17(4 Pt 1):557–566. doi: 10.1161/01.cir.17.4.557. [DOI] [PubMed] [Google Scholar]
- FIFER W. R., WOELLINER R. C., GORDON S. S. MEDIASTINAL HISTOPLASMOSIS. REPORT OF THREE CASES WITH DYSPHAGIA AS THE PRESENTING COMPLAINT. Dis Chest. 1965 May;47:518–526. doi: 10.1378/chest.47.5.518. [DOI] [PubMed] [Google Scholar]
- FLYNN J. E., SIEBENS A. A., WILLIAMS S. F. Congenital absence of a main branch of the pulmonary artery. Am J Med Sci. 1954 Dec;228(6):673–679. [PubMed] [Google Scholar]
- FREESTONE D. S. POSSIBLE RETROPERITONEAL FIBROSIS AND METHYSERGIDE. Lancet. 1965 May 29;1(7396):1168–1168. doi: 10.1016/s0140-6736(65)92000-3. [DOI] [PubMed] [Google Scholar]
- GARAMELLA J. J., STUTZMAN F. L., VARCO R. L., JENSEN N. K. Subcarinal mediastinal granulomas causing esophageal obstruction. J Thorac Surg. 1955 Aug;30(2):187–201. [PubMed] [Google Scholar]
- HACHE L., WOOLNER L. B., BERNATZ P. E. Idiopathic fibrous mediastinitis. Dis Chest. 1962 Jan;41:9–25. doi: 10.1378/chest.41.1.9. [DOI] [PubMed] [Google Scholar]
- HEATH D., EDWARDS J. E. Histological changes in the lung in diseases associated with pulmonary venous hypertension. Br J Dis Chest. 1959 Jan;53(1):8–18. doi: 10.1016/s0007-0971(59)80105-4. [DOI] [PubMed] [Google Scholar]
- HECHT H. H. Heart failure and lung disease. Circulation. 1956 Aug;14(2):265–290. doi: 10.1161/01.cir.14.2.265. [DOI] [PubMed] [Google Scholar]
- HEGGLIN R., ZOLLINGER H. Uber einen Fall von Pulmonalsklerose besonderer Atiologie; Narbengewebe im Mediastinum. Cardiologia. 1954;24(2):92–95. [PubMed] [Google Scholar]
- HURWITZ A., CALABRESI M., COOKE R. W., LIEBOW A. A. An experimental study of the venous collateral circulation of the lung. I. Anatomical observations. Am J Pathol. 1954 Nov-Dec;30(6):1085–1115. [PMC free article] [PubMed] [Google Scholar]
- KONN G. Die pathologische Morphologie der Lungengefässe bei chronischem Cor pulmonale; ein Beitrag zur Atiologie und zu den Folgen der chronischen pulmonalen Hypertonie. Beitr Pathol Anat. 1956;116(2):273–329. [PubMed] [Google Scholar]
- KUNKEL W. M., Jr, CLAGETT O. T., McDONALD J. R. Mediastinal granulomas. J Thorac Surg. 1954 Jun;27(6):565–574. [PubMed] [Google Scholar]
- LANDRIGAN P. L., PURKIS I. E., ROY D. E., CUDKO WICZ L. Cardio-respiratory studies in a patient with an absent left pulmonary artery. Thorax. 1963 Mar;18:77–82. doi: 10.1136/thx.18.1.77. [DOI] [PMC free article] [PubMed] [Google Scholar]
- MAIER H. C. Absence or hypoplasia of a pulmonary artery with anomalous systemic arteries to the lung. J Thorac Surg. 1954 Aug;28(2):145–162. [PubMed] [Google Scholar]
- MARSHALL R. J., EDMUNDOWICZ A. C., ANDREWS C. E. CHRONIC OBSTRUCTION OF THE SUPERIOR VENA CAVA DUE TO HISTOPLASMOSIS. A HEMODYNAMIC AND ANGIOGRAPHIC CORRELATION. Circulation. 1964 Apr;29:SUPPL–SUPPL:609. doi: 10.1161/01.cir.29.4.604. [DOI] [PubMed] [Google Scholar]
- MCGUIRE L. B., NOLAN T. B., REEVE R., DAMMANN J. F., Jr COR TRIATRIATUM AS A PROBLEM OF ADULT HEART DISEASE. Circulation. 1965 Feb;31:263–272. doi: 10.1161/01.cir.31.2.263. [DOI] [PubMed] [Google Scholar]
- Morgan A. D., Loughridge L. W., Calne R. Y. Combined mediastinal and retroperitoneal fibrosis. Lancet. 1966 Jan 8;1(7428):67–70. doi: 10.1016/s0140-6736(66)92360-9. [DOI] [PubMed] [Google Scholar]
- NELSON W. P., LUNDBERG G. D., DICKERSON R. B. PULMONARY ARTERY OBSTRUCTION AND COR PULMONALE DUE TO CHRONIC FIBROUS MEDIASTINITIS. Am J Med. 1965 Feb;38:279–285. doi: 10.1016/0002-9343(65)90182-8. [DOI] [PubMed] [Google Scholar]
- NIWAYAMA G. Cor triatriatum. Am Heart J. 1960 Feb;59:291–317. doi: 10.1016/0002-8703(60)90287-8. [DOI] [PubMed] [Google Scholar]
- OAKLEY C., GLICK G., McCREDIE R. M. Congenital absence of a pulmonary artery. Report of a case, with special reference to the bronchial circulation and review of the literature. Am J Med. 1963 Feb;34:264–271. doi: 10.1016/0002-9343(63)90061-5. [DOI] [PubMed] [Google Scholar]
- QUE G. S., MANDEMA E. A CASE OF IDIOPATHIC RETROPERITONEAL FIBROSIS PRESENTING AS A SYSTEMIC COLLAGEN DISEASE. Am J Med. 1964 Feb;36:320–329. doi: 10.1016/0002-9343(64)90095-6. [DOI] [PubMed] [Google Scholar]
- RAPER F. P. Idiopathic retroperitoneal fibrosis involving the ureters. Br J Urol. 1956 Dec;28(4):436–446. doi: 10.1111/j.1464-410x.1956.tb04795.x. [DOI] [PubMed] [Google Scholar]
- REED W. G., STINLEY R. W. Massive periaortic and periarterial fibrosis; report of a case. N Engl J Med. 1959 Aug 13;261(7):320–323. doi: 10.1056/NEJM195908132610702. [DOI] [PubMed] [Google Scholar]
- SALYER J. M., HARRISON H. N., WINN D. F., Jr, TAYLOR R. R. Chronic fibrous mediastinitis and superior vena caval obstruction due to histoplasmosis. Dis Chest. 1959 Apr;35(4):364–377. doi: 10.1378/chest.35.4.364. [DOI] [PubMed] [Google Scholar]
- SCADDING J. G. FIBROSING ALVEOLITIS. Br Med J. 1964 Sep 12;2(5410):686–686. doi: 10.1136/bmj.2.5410.686. [DOI] [PMC free article] [PubMed] [Google Scholar]
- SHERRICK D. W., KINCAID O. W., DUSHANE J. W. Agenesis of a main branch of the pulmonary artery. Am J Roentgenol Radium Ther Nucl Med. 1962 May;87:917–928. [PubMed] [Google Scholar]
- SMART J., PATTINSON J. N. Congenital absence of left pulmonary artery. Br Med J. 1956 Mar 3;1(4965):491–493. doi: 10.1136/bmj.1.4965.491. [DOI] [PMC free article] [PubMed] [Google Scholar]
- STOVIN P. G., MITCHINSON M. J. PULMONARY HYPERTENSION DUE TO OBSTRUCTION OF THE INTRAPULMONARY VEINS. Thorax. 1965 Mar;20:106–113. doi: 10.1136/thx.20.2.106. [DOI] [PMC free article] [PubMed] [Google Scholar]
- TABAKIN B. S., HANSON J. S., ADHIKARI P. K., MILLER D. B. Physiologic studies in congenital absence of the left main pulmonary artery. Circulation. 1960 Dec;22:1107–1111. doi: 10.1161/01.cir.22.6.1107. [DOI] [PubMed] [Google Scholar]
- TOURNIAIRE A., TREPPOZ M., TARTULIER M., DEYRIEUX F., VAN STRAATEN G. Coeur pulmonaire chronique par compression artérielle pulmonaire dans la maladie du hile d'origine ganglionnaire. Arch Mal Coeur Vaiss. 1958 Oct;51(10):960–967. [PubMed] [Google Scholar]
- TREVER R. W. Reticulum-cell sarcoma producing retroperitoneal and periureteric fibrosis; report of a case. N Engl J Med. 1958 Feb 6;258(6):268–270. doi: 10.1056/NEJM195802062580603. [DOI] [PubMed] [Google Scholar]
- UTZ D. C., ROOKE E. D., SPITTELL J. A., Jr, BARTHOLOMEW L. G. RETROPERITONEAL FIBROSIS IN PATIENTS TAKING METHYSERGIDE. JAMA. 1965 Mar 22;191:983–985. doi: 10.1001/jama.1965.03080120017005. [DOI] [PubMed] [Google Scholar]
- YACOUB M. H., BELCHER J. R., PATTINSON J. N. UNILATERAL PULMONARY ARTERY HYPOPLASIA ASSOCIATED WITH CONGENITAL CARDIAC ANOMALIES. Br J Dis Chest. 1965 Apr;59:102–112. doi: 10.1016/s0007-0971(65)80018-3. [DOI] [PubMed] [Google Scholar]
- Yacoub M. H., Pattinson J. N., Ohnsorge J. Angeborene Hypoplasie einer Lungenarterie. Thoraxchir Vask Chir. 1965 Oct;13(5):346–356. doi: 10.1055/s-0028-1100754. [DOI] [PubMed] [Google Scholar]










