Not All That Wheezes Is Asthma: A Pediatric Posterior Mediastinal Ganglioneuroma Mimicking Recurrent Asthma

Abstract

Wheezing in children is often attributed to asthma, but structural thoracic lesions may mimic asthma and delay diagnosis. Ganglioneuromas are rare benign tumors of neural crest origin, usually discovered incidentally, with thoracic localizations being uncommon. We report a 7-year-old boy with a history of recurrent wheezing episodes treated as asthma, who presented with acute respiratory distress and fever. Chest radiography revealed a right lower lobe opacity, while chest CT showed a posterior mediastinal mass. Histopathological examination confirmed a schwannian component of ganglioneuroma, without neuroblastic elements or malignancy. This case highlights the importance of careful interpretation of chest radiography in children with persistent or atypical wheezing. Not every wheeze is asthma; mediastinal masses should be considered in the differential diagnosis.