Pulmonary hyalinizing granuloma (PHG) is a rare, benign lung disease of unknown etiology. It manifests as discrete, rounded nodules within the lung parenchyma. A 39-year-old woman presented for investigation after pulmonary nodules were found incidentally. Chest computed tomography showed multiple, discrete, non-enhancing pulmonary nodules bilaterally. Positron emission tomography (PET) was negative. Biopsy demonstrated a non-specific lymphoplasmacytic infiltrate. Open resection yielded two nodules consistent with hyalinizing granulomas. The differential for multiple pulmonary nodules is broad. PET scan can help rule out metastatic disease, although some cancers are not hypermetabolic on PET. Furthermore, some non-malignant conditions, including hyalinizing granuloma, can show increased activity on PET. PHG should be included in the differential of multiple pulmonary nodules, especially if nodule stability can be demonstrated and/or needle biopsies are non-diagnostic. Associated immune-mediated conditions, such as idiopathic thrombocytopenic purpura (ITP) in our patient, may also favor HG. In this case report we find an association between PHG and ITP.
Muhammad Adnan Saleem, Rahul Bhat and Bidisa Sinha (2017) Solitary pulmonary hyalinising granuloma: a rare cause of pulmonary nodule. BJR|case reports3(2):20160055. doi: 10.1259/bjrcr.20160055
Nico S. Rosinus, Detlef Kirsten and Michael Kreuter (2018) Seltene Erkrankung mit vielen Gesichtern. Pneumo News10(6):6. doi: 10.1007/s15033-018-1012-x
Fazal Khan, Arsalan Hamid, Benish Fatima, Shiraz Hashmi and Saulat Fatimi (2017) Pulmonary hyalinizing granuloma presenting with dysphagia: a rare presentation. Asian Cardiovasc Thorac Ann25(1):67. doi: 10.1177/0218492316684983
Elias Amorim, Raimunda Ribeiro da Silva and Armando da Veiga Cruz Filho (2016) Pulmonary Hyalinizing Granuloma: A Case Report. OJTS06(04):70. doi: 10.4236/ojts.2016.64009
Raphael Lhote, Julien Haroche, Loïc Duron, Nicolas Girard, Marie Pierre Lafourcade, Michel Martin, Hugues Begueret, André Taytard, Frédérique Capron, Philippe Grenier, Jean Charles Piette, Fleur Cohen-Aubart and Zahir Amoura (2017) Pulmonary hyalinizing granuloma: a multicenter study of 5 new cases and review of the 135 cases of the literature. Immunol Res65(1):375. doi: 10.1007/s12026-016-8852-4
This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-Share Alike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.