Publish in this journal
Journal Information
Vol. 54. Issue 9.
Pages 479 (September 2018)
Vol. 54. Issue 9.
Pages 479 (September 2018)
Clinical image
DOI: 10.1016/j.arbr.2018.07.006
Full text access
Pulmonary Hyalinizing Granuloma: A Diagnostic Challenge
Granulomas hialinizantes pulmonares, un reto diagnóstico
Visits
211
Ana Belén Gil Guerra
Corresponding author
anagil.guerra@gmail.com

Corresponding author.
, María Rosa López Pedreira, Pilar Cartón Sánchez
Servicio de Radiodiagnóstico, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
This item has received
211
Visits
Article information
Full Text
Bibliography
Download PDF
Statistics
Figures (1)
Full Text

A 57-year-old woman, smoker with no other history of interest, presented with a 1-week history of dyspnea, cough with expectoration, and low-grade fever. Chest X-ray showed multiple bilateral nodular images, some of which were cavitary (Fig. 1a). Computed tomography (CT) confirmed the presence of multiple cavitary masses in both hemithoraxes, with amorphous calcifications (Figs. 1b and c). Serology for hydatidosis was negative, and sputum and bronchial aspirate cultures for mycobacteria on Löwenstein medium were also negative.

Figure 1.

(a) Standard chest X-ray: multiple nodular images in both lung fields, some cavitary; (b) chest CT scan (pulmonary parenchyma window): pulmonary nodules with central cavitation and pleuroparenchymal retraction (arrow); (c) chest CT scan (mediastinum window): cavitary nodule with amorphous internal calcification (arrow); and (d) histology, showing a formation of dense collagen tissue with central calcium microdeposits and accumulations of lymphocytes in the central and peripheral areas (hematoxylin–eosin 40×).

(0.27MB).

Transbronchial biopsy was inconclusive, so a surgical biopsy was performed. Macroscopic examination showed at least 4 whitish nodules of hard consistency with pleural retraction and pleuropulmonary adhesions. The nodule submitted for histological study consisted of dense collagen tissue, with central calcium microdeposits and accumulations of lymphocytes (Fig. 1d). Findings were compatible with pulmonary hyalinizing granuloma (PHG).

PHG is a rare disease1,2 that typically occurs in middle-aged patients with non-specific respiratory manifestations or general symptoms.2 Invasive techniques are necessary for histologic diagnosis.1 Although the physiopathology of this entity is unclear, the origin is assumed to be immunological.1,2 Prognosis is good,1 and treatment is not usually required, although corticosteroids have demonstrated efficacy.1,2

References
[1]
R. Lhote, J. Haroche, L. Duron, N. Girard, M.P. Lafourcade, M. Martin, et al.
Pulmonary hyalinizing granuloma: a multicenter study of 5 new cases and review of the 135 cases of the literature.
Immunol Res, 65 (2017), pp. 375-385
[2]
K. Pfeifer, A. Mian, A. Adebowale, A. Alomari, V. Kalra, E. Krejci, et al.
Radiographic and pathologic manifestations of uncommon and rare pulmonary lesions.
Can Assoc Radiol J, 67 (2016), pp. 179-189

Please cite this article as: Guerra ABG, Pedreira MRL, Sánchez PC. Granulomas hialinizantes pulmonares, un reto diagnóstico. Arch Bronconeumol. 2018;54:479.

Copyright © 2018. SEPAR
Idiomas
Archivos de Bronconeumología (English Edition)

Subscribe to our newsletter

Article options
Tools
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

es en
Política de cookies Cookies policy
Utilizamos cookies propias y de terceros para mejorar nuestros servicios y mostrarle publicidad relacionada con sus preferencias mediante el análisis de sus hábitos de navegación. Si continua navegando, consideramos que acepta su uso. Puede cambiar la configuración u obtener más información aquí. To improve our services and products, we use "cookies" (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here.