DISCUSSION: In our case patient’s young age, gradual development of the symptoms with development of the collateral circulation, and absence of a mass constricting SVC all suggest SVC of benign etiology. Based on the collection of radiological findings and history of Histoplasmosis, our patient was diagnosed with FM. FM may constitute approximately half of the cases of SVC syndrome. Theorotically, FM secondary to Histoplasmosis is thought to occur due to leaking of antigen in mediastinum leading to progressive fibrosis. Diagnosis is usually made based on radiological findings, and also help in assessing extent of involvement and disease progression. Invasive diagnostic biopsies are not usually recommended given the risk of pulmonary hemorrhage unless diagnosis is not clear based on radiological findings. FM result in structural changes that are unresponsive to antifungal agents. In contrast, FM usually respond to interventions directed to relief obstruction, such as stent placement in our case.