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Case report


Pulmonary hyalinizing granuloma associated with idiopathic thrombocytopenic purpura.

Christopher ColemanAziza NassarBarbara McComb
Departments of Diagnostic Radiology, and Pathology, Mayo Clinic, Jacksonville, FL 32224, USA
Date of Submission: 19-Dec-2013, Date of Acceptance: 09-Feb-2014, Date of Web Publication: 25-Feb-2014.
Corresponding Author:
Corresponding Author

Christopher Coleman

Department of Diagnostic Radiology, Mayo Clinic, Mayo 2‑131S, 4500 San Pablo Road, Jacksonville, FL 32224, USA.
E-mail: Coleman.christopher@mayo.edu

Corresponding Author:
Corresponding Author

Christopher Coleman

Department of Diagnostic Radiology, Mayo Clinic, Mayo 2‑131S, 4500 San Pablo Road, Jacksonville, FL 32224, USA.
E-mail: Coleman.christopher@mayo.edu

DOI: 10.4103/2156-7514.127835 Facebook Twitter Google Linkedin

ABSTRACT


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.
Keywords: Hyalinizing Granuloma, Nodule, Pulmonary

Cited in 5 Documents

  1. Muhammad Adnan Saleem, Rahul Bhat and Bidisa Sinha (2017) Solitary pulmonary hyalinising granuloma: a rare cause of pulmonary nodule. BJR|case reports 3(2):20160055. doi: 10.1259/bjrcr.20160055
  2. Nico S. Rosinus, Detlef Kirsten and Michael Kreuter (2018) Seltene Erkrankung mit vielen Gesichtern. Pneumo News 10(6):6. doi: 10.1007/s15033-018-1012-x
  3. Fazal Khan, Arsalan Hamid, Benish Fatima, Shiraz Hashmi and Saulat Fatimi (2017) Pulmonary hyalinizing granuloma presenting with dysphagia: a rare presentation. Asian Cardiovasc Thorac Ann 25(1):67. doi: 10.1177/0218492316684983
  4. Elias Amorim, Raimunda Ribeiro da Silva and Armando da Veiga Cruz Filho (2016) Pulmonary Hyalinizing Granuloma: A Case Report. OJTS 06(04):70. doi: 10.4236/ojts.2016.64009
  5. 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 Res 65(1):375. doi: 10.1007/s12026-016-8852-4

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