{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T23:17:57Z","timestamp":1790983077751,"version":"4.1.0"},"reference-count":11,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,8,2]]},"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:p>Woman in her 30s presented with dry cough and shortness of breath since 8 months and swelling of the face and lower limbs since 2 months. Imaging revealed a fluorodeoxyglucose-avid mediastinal mass encasing the superior vena cava and right pulmonary artery, raising a strong suspicion for malignancy. Investigations, including extensive serological testing, bronchoscopy with endobronchial ultrasound lymph node sampling and thoracoscopic biopsy, excluded secondary causes. Histopathology demonstrated dense fibrocollagenous tissue with lymphoplasmacytic infiltrates, confirming idiopathic fibrosing mediastinitis. She showed minimal response to corticosteroids and tamoxifen but exhibited substantial clinical and radiological improvement following rituximab therapy. This highlights the diagnostic complexity of idiopathic fibrosing mediastinitis and supports the emerging role of B-cell-directed immunotherapy in refractory cases.<\/jats:p>","DOI":"10.1136\/bcr-2026-274855","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T11:15:20Z","timestamp":1787570120000},"page":"e274855","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Idiopathic fibrosing mediastinitis mimicking malignancy: when imaging deceives"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4434-7850","authenticated-orcid":false,"given":"Varuna","family":"Jethani","sequence":"first","affiliation":[{"name":"Department of Respiratory Medicine, Swami Rama Himalayan University HIMS, Dehradun, Uttarakhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohan","family":"Venkatesh","sequence":"additional","affiliation":[{"name":"Department of Chest Onco-surgery and Lung Transplant, Medanta The Medicity, Gurugram, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yogesh Preet","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, AIIMS, Bilaspur, Himachal Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kartika","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Swami Rama Himalayan University HIMS, Dehradun, Uttarakhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,8,24]]},"reference":[{"key":"2026082404151363000_19.8.e274855.1","doi-asserted-by":"publisher","DOI":"10.1097\/00005792-198809000-00002"},{"key":"2026082404151363000_19.8.e274855.2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.106.2.484"},{"key":"2026082404151363000_19.8.e274855.3","doi-asserted-by":"publisher","DOI":"10.1148\/radiographics.21.3.g01ma17737"},{"key":"2026082404151363000_19.8.e274855.4","first-page":"593","article-title":"Fibrosing mediastinitis: clinical presentation, diagnosis, and management","volume":"54","author":"Mathisen","year":"1992","journal-title":"Ann Thorac Surg"},{"key":"2026082404151363000_19.8.e274855.5","first-page":"285","article-title":"Mediastinal fibrosis","volume":"32","author":"Maldonado","year":"2011","journal-title":"Semin Respir Crit Care Med"},{"key":"2026082404151363000_19.8.e274855.6","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0b013e318237c8e6"},{"key":"2026082404151363000_19.8.e274855.7","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0b013e3182431ef6"},{"key":"2026082404151363000_19.8.e274855.8","first-page":"79","article-title":"Successful treatment of idiopathic fibrosing mediastinitis with rituximab","volume":"22","author":"Ghobrial","year":"2017","journal-title":"Respir Med Case Rep"},{"key":"2026082404151363000_19.8.e274855.9","first-page":"1098","article-title":"Fibrosing mediastinitis: contemporary review of pathogenesis, diagnosis and management","volume":"144","author":"Westerly","year":"2013","journal-title":"Chest"},{"key":"2026082404151363000_19.8.e274855.10","first-page":"555","article-title":"Muller NL.CT of fibrosing mediastinitis: findings and their utility","volume":"162","author":"Hartman","year":"1994","journal-title":"AJR Am J Roentgenol"},{"key":"2026082404151363000_19.8.e274855.11","first-page":"e75","article-title":"PET in the evaluation of fibrosing mediastinitis: correlation with disease activity","volume":"74","author":"Inoue","year":"2010","journal-title":"Eur J"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2026-274855","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T11:15:22Z","timestamp":1787570122000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2026-274855"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8]]},"references-count":11,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,8,24]]},"published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1136\/bcr-2026-274855"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2026-274855","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8]]}}}