Low Cellular Sclerosis of Anterior Mediastinum

CT-guided Biopsy with Hydrodissection of this Rare Entity - Case Report

Authors

DOI:

https://doi.org/10.59667/sjoranm.v3i1.10

Keywords:

CT-guided biopsy, low cellular mediastinal sclerosis, sclerosing mediastinitis, aortic arch mass, retrosternal pleural hydrodissection

Abstract

Conducting a CT-guided interventional procedure involving retrosternal pleural hydro-dissection of the juxta-aortic anterior mediastinum under local anesthesia revealed a rare histopathological condition known as benign mediastinal sclerosis. This challenging CT-guided intervention within the anterior mediastinum is scarcely documented in the existing scientific literature. In this presentation, we share our case along with relevant clinical data. What makes this case distinctive is that the clinicians initially questioned the representativeness of the biopsy sample we obtained. Consequently, an additional sample was acquired through a highly invasive video-assisted mediastinoscopy procedure under intubation anesthesia. Remarkably, this second sample yielded the same histopathological result.

Mediastinal sclerosis is an exceedingly rare condition, often referred to as the "burnt-out" stage of sclerosing mediastinitis. While infectious etiologies are frequently identified, the majority of cases remain idiopathic.

Author Biographies

  • Frank Mosler, Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, University Hospital of Bern, University of Bern

    Board-certified Radiologist & Neuroradiologist; Senior Consultant, Inselspital, Bern University Hospital

    Dr. med. Frank Mosler is a board-certified radiologist and neuroradiologist with more than 30 years of clinical and academic experience across major European university centers. He completed his medical education and early specialty training in radiology and neurosurgery at Charité University Hospital in Berlin. He later specialized in interventional neuroradiology at Alfried Krupp Hospital in Essen, where he also held senior leadership responsibilities.

    His professional career has included academic medicine, diagnostic and interventional radiology, neuroradiology, healthcare management, quality assurance, and scientific publishing in Germany and Switzerland. Since 2017, he has been affiliated with the Department of Diagnostic, Interventional and Pediatric Radiology (DIPR) at Inselspital, Bern University Hospital.

    As Editor-in-Chief of the Swiss Journal of Radiology and Nuclear Medicine, Dr. Mosler leads the journal's editorial and scientific strategy and holds overall responsibility for editorial policy, publication standards, scientific integrity, and final editorial decision-making.

    Institutional affiliation: University Institute of Diagnostic, Interventional and Pediatric Radiology, Inselspital
    Location: Bern, Switzerland
    ROR: 01q9sj412

  • Gerd Nöldge, Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, University of Bern, CH-3010 Bern, Switzerland, University of Bern, University Hospital of Bern

    Founding Editor & Honorary Editor
    Switzerland & Germany
    Senior Consultant Radiology, University Hospitals Heidelberg & Bern

    Prof. Dr. med. Gerd Nöldge is a renowned German radiologist and pioneer in interventional radiology. As former Senior Consultant at Heidelberg University Hospital, he made groundbreaking contributions to gastrointestinal artery embolization, for which he received the inaugural Wilhelm Conrad Röntgen Prize in 1985. He played a key role in advancing kyphoplasty techniques for osteoporotic vertebral fractures, providing long-term evidence for the efficacy and stability of calcium phosphate cement in vertebral body augmentation.

    Prof. Nöldge has also significantly contributed to the clinical development and refinement of transjugular intrahepatic portosystemic shunt (TIPS) procedures, improving outcomes in patients with portal hypertension. His dedication to education and international collaboration has fostered enduring partnerships, including medical exchange programs with leading institutions in China.

    As Founding Editor of the Swiss Journal of Radiology and Nuclear Medicine, Prof. Nöldge played a decisive role in the establishment and early development of SJORANM. His appointment as Honorary Editor recognizes his founding contribution, his longstanding scientific commitment, and his lasting importance to the journal. 

    Former institutional affiliation: University Hospital Heidelberg – Diagnostic and Interventional Radiology
    Location: Heidelberg, Germany & Bern, Switzerland
    ROR: 013czdx64

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SJORANM article cover, Vol. 3 No. 1 (2023). Holographic symbolic illustration for article 12.

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Published

2023-09-30

Issue

Vol. 3 No. 1 (2023)

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Case reports

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Copyright (c) 2023 Daniela Lavric, Frank Mosler, Nour Maalouf, Roua Ben Ayed, Gerd Nöldge, Andreas Mahnken, Jonas C. Apitzsch

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How to Cite

Lavric, D., Mosler, F., Maalouf, N., Ben Ayed, R., Nöldge, G., Mahnken, A., & Apitzsch, J. C. (2023). Low Cellular Sclerosis of Anterior Mediastinum: CT-guided Biopsy with Hydrodissection of this Rare Entity - Case Report. Swiss Journal of Radiology and Nuclear Medicine, 3(1), 1-8. https://doi.org/10.59667/sjoranm.v3i1.10

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