<s>[INST] I have been diagnosed with a mediastinal mass. In 1996, I had 2 thoracic surgeries due to cryptococcal pneumonia. I lost my upper left lobe of my lung cavity. Ten days later had to have a pericardium graft to seal my lower left lobe that the pneumonia had begun to damage. I took several rounds of diflucan antibiotics till my blood cell counts returned to normal. I m currently being seen by pulmonary specialist who feels that this mass is a result of scar tissue. Over past year I have noticed changes with my pain level, night sweats, shortness of breath, etc. anxiety / stress causes my chest to constrict as if a boa constrictor is squeezing the breath out of me. By having the 2 surgeries I lost 4 of my 5th left rib when I was only to loose 4cm! In the beginning my doctor diagnosed my situation as being scar tissue, another physician referred to it as a left hilar mass, now they refer to it as a mediastinal mass. I m scheduled for a pft test this week & have had chest X-ray last march, followed by cat scan w/ contrast last April ,& finally a cat scan this past Friday but contrast couldn t be used because after 8 attempts to have an IV contrast was cancelled. Medical assistants stated I wasn t dehydrated. They could pull the blood but when they tried to flush either vein blew or dried up . Specialist says I m not a surgical candidate . They do consistently use the term mass & not tumor. What s the difference & chances of my recovery? [/INST] Hi Dear !! Thanks for your query to Chat Doctor. Read and reviewed your query and health concerns. You seem to suffer from -Streptococcal Pneumonia with fibrotic lung and with COPD. Mediastinal Mass could be from-Scarring or Could be from Cryptococciosis spread from streptococcal Lung infection which was excised last. Because of this extensive mediastinal mass, Specialist says yo you're not a surgical candidate. They do consistently use the term mass & not tumor. Q- What's the difference-Ans-NO practical difference, but in your case-it has different meaning-like-you mostly have extensive -radio-opaque mass-in mediastinum, indicating extensive lung lesion spreading to mediastinum also. Only possibility of care and cure -is by antifungal medicines. & chances of my recovery-are grim in your case. But see if you get benefits from antifungal medicines. Hope this would help you to plan further care of this complex illness of yours. If need be, update any health issue 24 x 7 by a direct question to ME, at following Chat Doctor link-Dear, if satisfied, Dont forget to close this query with YOUR pleasing feedback comments to rate this reply and service, to boost the morale of incoming Emergency patients like YOU, at Chat Doctor services. If you want to update more details and ask more update queries, You are most Welcome herewith !! Good Day!! Wishing Good Healthy Life in time to come!! Chat Doctor. N. Senior Surgical Specialist. S. Genl-CVTS </s>