Correct!
5. Rituximab
There is no standard therapy for fibrosing mediastinitis. Prednisone, tamoxifen, non-steroid anti-inflammatory medication such as indomethacin, and immunosuppressants such as azathioprine or cyclosporin have all been tried and have proven disappointing or have limited data available about their effectiveness (2). Physicians at the Mayo Clinic have now treated almost 30 patients with metabolically active (confirmed by PET-CT), progressive fibrosing mediastinitis with rituximab. Disease progression was almost universally halted, 67% of patients improved symptomatically and the noncalcified areas decreased on average by 41% (3-5).
The present patient was treated with 2 courses of rituximab and her PET/CT scan was repeated (Figure 4).
Figure 4. Repeat thoracic PET/CT scan after 2 courses of rituximab.
Her PET/CT scan showed improvement compared to the one done about 7 months earlier. She was symptomatically improved and is being followed.
References