Pulmonary infarct: an unusual manifestation of fibrosing mediastinitis

We have recently seen lung biopsy specimens showing pulmonary infarcts in two patients with fibrosing mediastinitis. The patients were young, and in each, the infarcts were the first manifestation of the underlying mediastinal fibrosis. The infarcts had several distinctive histologic features and may have been caused by constriction of major pulmonary veins by the fibrosis.