TY - JOUR T1 - Fibrosing mediastinitis as a rare mechanism of pulmonary oedema in sarcoidosis JF - European Respiratory Journal JO - Eur Respir J SP - 455 LP - 456 DO - 10.1183/09031936.00132909 VL - 35 IS - 2 AU - F. Yangui AU - J-P. Battesti AU - D. Valeyre AU - A. B. Kheder AU - P-Y. Brillet Y1 - 2010/02/01 UR - http://erj.ersjournals.com/content/35/2/455.abstract N2 - To the Editors: Pulmonary oedema in sarcoidosis can usually be attributed to congestive heart failure or veno-occlusive disease. Here we report a rare case of pulmonary oedema, which was due to pulmonary vein stenosis secondary to fibrosing mediastinitis. Our patient was a 44-yr-old female who was admitted to our hospital because of acute dyspnoea. She had a histogically confirmed cutaneous sarcoidosis diagnosed 17 yrs prior to presentation at our hospital and had received aminoquinolins for 9 yrs. 1-yr prior to presentation at our institute, pulmonary involvement was diagnosed based on clinical complaints (progressive dyspnoea and non-productive cough) and diffuse pulmonary infiltration with bilateral hilar enlargement on chest radiography. On admission to our hospital, the patient was orthopnoeic and polypnoeic, and had dilatation of jugular veins suggesting congestive cardiac failure. Arterial blood gases in room air showed hypoxaemia (an arterial oxygen tension level of 62 mmHg) and hypocapnia (a carbon dioxide arterial tension of 30 mmHg). Transthoracic echocardiography showed right ventricular dilatation and high systolic pulmonary artery pressure at 45 mmHg, while the left ventricular function appeared normal. Pulmonary ventilation–perfusion scintigraphy showed mismatched perfusion defects in the upper left lobe and matched ventilation–perfusion defects in the right lung. Contrast-enhanced computed tomography (CT) (fig. 1⇓) showed: soft-tissue attenuation mediastinal masses with scare … ER -