High-resolution CT findings in pulmonary hyalinizing granuloma.

Published on Nov 1, 2007in Journal of Thoracic Imaging2.19
· DOI :10.1097/RTI.0B013E31805BA3AE
Yoshihiro Shibata5
Estimated H-index: 5
(Kanazawa University),
Takeshi Kobayashi60
Estimated H-index: 60
+ 5 AuthorsYasuhiko Ohta21
Estimated H-index: 21
A 47-year-old man with pulmonary hyalinizing granuloma is herein presented. The patient, whose chief complaint was a mild cough, was found by chest radiograph to have multiple bilateral nodules. Subsequent high-resolution computed tomography demonstrated multiple slightly irregular nodules, perinodular ground-glass opacity, peribronchovascular interstitial thickening, and cysts. A mild enlargement of systemic lymph nodes was also noted. Laboratory tests disclosed a slight elevation in the C-reactive protein, γ-globulin, interleukin-6, and soluble interleukin-2 receptor levels. A histopathologic examination of the specimen yielded from a thoracoscopic lung biopsy resulted in a definite diagnosis of pulmonary hyalinizing granuloma.
📖 Papers frequently viewed together
12 Citations
2 Citations
#1Yafei Ren (KU: University of Kansas)H-Index: 2
#2ElizabethAnn N. Raitz (KU: University of Kansas)H-Index: 1
Last. Ossama Tawfik (KU: University of Kansas)H-Index: 47
view all 5 authors...
A case of pulmonary hyalinizing granuloma (PHG) and concomitant low-grade, small lymphocytic lymphoma of the lung is presented. This is the first occurrence of pulmonary lymphoma in patients with PHG ever reported. The infiltrates around a left lower lobe nodule with left pleural effusion and thickening seen on chest CT were histologically proven to be lymphomatous infiltrates of the lung, pleura, and chest wall muscle. We believe that the lymphoma developed around the nodule and spread to the p...
38 CitationsSource
#1Takeshi Johkoh (Osaka University)H-Index: 69
#2Nestor L. MüllerH-Index: 130
Last. Satoru YamamotoH-Index: 24
view all 10 authors...
PURPOSE: To assess the computed tomographic (CT) findings of intrathoracic involvement in multicentric Castleman disease. MATERIALS AND METHODS: The study comprised 12 patients with lymph node biopsy-proved Castleman disease and multicentric involvement. The patients were aged 23-58 years (mean age, 42.9 years; five men, seven women). Seven patients underwent open lung biopsy (n = 3) or transbronchial lung biopsy (n = 4), which demonstrated lymphocytic interstitial pneumonitis. RESULTS: All pati...
102 CitationsSource
#1Shinji AtagiH-Index: 30
#2Mitsunori SakataniH-Index: 28
Last. Einosuke UedaH-Index: 12
view all 5 authors...
A case of pulmonary hyalinizing granuloma (PHG) with Castleman's disease in a 43-year-old man is presented. He was asymptomatic, but the disease was recognized due to a routine chest roentgenographic study. Anemia, multiple lymphadenopathy, hypoalbuminemia and polyclonal hypergamma-globulinemia were observed. Histological examination of cervical lymph nodes revealed the plasma cell type of Castleman's disease. The diagnosis of PHG was confirmed by video-assisted thoracoscopical lung biopsy, and ...
17 CitationsSource
#1Taijiro Ishiyama (Showa University)H-Index: 7
#2Shinji Nakamura (Juntendo University)H-Index: 16
Last. Shyozo ChibaH-Index: 2
view all 10 authors...
Summary. To study the pathogenesis of multicentric Castleman's disease (MCD), IL-6 producing cells and immune function were investigated in four MCD patients. The expression of IL-6 mRNA in one MCD lymph node was analysed by in situ hybridization. IL-6 mRNA expressing cells were scattered in the interfollicular areas and did not resemble plasma cells. Spontaneous IL-6 production was detected in the culture supernatants of peripheral blood mononuclear cells (PBMNC) from four patients. The IL-6 pr...
43 CitationsSource
#1J M ChessellsH-Index: 31
#2Alison LeiperH-Index: 9
Last. Susan M. RichardsH-Index: 40
view all 3 authors...
We report the results of long-term follow-up of 94 children who completed treatment for acute lymphoblastic leukaemia (ALL) between 1974 and 1986 and subsequently experienced a bone marrow relapse before 1992. 91 children received further induction, intensification and CNS directed therapy; 19 proceeded to BMT or ABMT and the remainder were treated on one of three protocols which increased in intensity. The duration of second remission improved significantly with increasing intensity of treatmen...
32 CitationsSource
#1Yatish PatelH-Index: 1
#2Sadamu IshikawaH-Index: 1
Last. Kenneth F. MacDonnellH-Index: 2
view all 3 authors...
We describe a patient with PHG who presented with multiple cavitary calcified nodules. Laboratory evaluations revealed that she had serum immune abnormalities, and a histoplasmin skin test yielded positive results. Her Histoplasma infection may have produced a hyperimmune reaction that resulted in PHG and the calcified nodules.
29 CitationsSource
#1Eschelman Dj (BMC: Boston Medical Center)H-Index: 1
#2Johan G. BlickmanH-Index: 41
Last. Schechter MH-Index: 1
view all 5 authors...
: Pulmonary hyalinizing granulomata are unusual, noninfectious lesions of the lung of uncertain etiology that probably represent an exaggerated immune response. They present radiographically as noncalcified solitary or multiple pulmonary nodules, thereby mimicking primary or metastatic malignancy. The article discusses a case of this rare entity that presented as a solitary pulmonary nodule.
16 CitationsSource
#1Kazuyuki Yoshizaki (Osaka University)H-Index: 65
#2Tadashi Matsuda (Osaka University)H-Index: 70
Last. Toshihisa Komori (Osaka University)H-Index: 71
view all 10 authors...
Castleman's disease is a syndrome consisting of giant lymph node hyperplasia with plasma cell infiltration, fever, anemia, hypergammaglobulinemia, and an increase in the plasma level of acute phase proteins. It has been reported that clinical abnormalities disappear after the resection of the affected lymph nodes, suggesting that products of lymph nodes may cause such clinical abnormalities. Interleukin-6 (IL-6) is a cytokine inducing B-cell differentiation to immunoglobulin-producing cells and ...
756 CitationsSource
#1Samuel A. Yousem (AFIP: Armed Forces Institute of Pathology)H-Index: 55
#2Liselotte Hochholzer (AFIP: Armed Forces Institute of Pathology)H-Index: 25
Abstract Pulmonary hyalinizing granulomas are distinct fibrosing lesions of lung, having central whorled deposits of lamellar collagen. Twenty-four cases of this unusual pulmonary lesion are reported herein. Hyalinizing granulomas occur in middle-aged persons and are frequently mistaken for metastatic carcinoma radiographically. More than half of the patients had autoimmune phenomena or previous exposures to mycobacterial or fungal antigens. Four patients had sclerosing mediastinitis develop. A ...
88 CitationsSource
#1J ChalaouiH-Index: 1
#2Grégoire PH-Index: 1
Last. R AmyotH-Index: 1
view all 5 authors...
The radiological and histological appearance of pulmonary hyalinizing granuloma (PHG) and its pathogenesis are described. The histological features bear a striking resemblance to fibrosing mediastinitis. Patients present clinically with nonspecific respiratory or general symptoms. Slowly growing solitary or, more often, multiple nodules are found on radiographs of the chest, suggesting neoplastic disease. Four patients with PHG are described. Four patients with PHG are described. One had lesions...
40 CitationsSource
Cited By11
#2N. MeloH-Index: 9
Last. A. Morais (University of Porto)H-Index: 7
view all 6 authors...
#1Annikka Weissferdt (University of Texas MD Anderson Cancer Center)H-Index: 21
In this chapter, various unusual non-neoplastic pulmonary disorders are discussed. This group of lesions encompasses a range of different conditions that may be of multifactorial, immunologic, genetic, or uncertain etiology. Awareness of the existence of these relatively rare disorders and their histopathological characteristics is necessary for the pathologist in order to avoid misdiagnosis.
#1Prasad M. PanseH-Index: 10
#2Brandon T. LarsenH-Index: 17
Last. Michael B. GotwayH-Index: 35
view all 6 authors...
Pulmonary nodules are a common abnormality detected at chest radiography, and even more so with thoracic computed tomography. Multiple pulmonary nodules are most commonly the result of previous granulomatous infection or metastatic disease. Less commonly, multiple pulmonary nodules may be the result
#1R. LhoteH-Index: 6
#2Julien Haroche (UPMC: Pierre-and-Marie-Curie University)H-Index: 24
Last. Z. Amoura (UPMC: Pierre-and-Marie-Curie University)H-Index: 26
view all 13 authors...
Pulmonary hyalinizing granuloma (PHG) is a rare disease characterized by single or multiple benign lung nodules mimicking lung neoplasma. Histologic analysis reveals homogenous hyaline lamellae, usually surrounded by collection of plasma cells, lymphocytes and histiocytes in a perivascular distribution. The clinical and radiological findings have been described in small series, but the long-term outcomes have rarely been reported. The objectives were to describe the clinical, radiological and ou...
14 CitationsSource
#1Jiaxuan ZhouH-Index: 1
#2Xian Li (Guangzhou Medical University)H-Index: 2
Last. Qingsi Zeng (Guangzhou Medical University)H-Index: 5
view all 3 authors...
IgG4-related lung disease is a rare disease, diagnosed when typical pathologic features are seen in the context of increased serum levels of IgG4 and the elevated tissue’s IgG4-positive plasma cells. Here we reported the case of a 24-year-old woman with IgG4-related lung disease. This patient presented with fever, cough and shortness of breath. Thoracic computed tomography (CT) images demonstrated multiple nodules or masses with high density in both lungs, and thickened interlobular septa. The ‘...
7 CitationsSource
#1Kamonpun Ussavarungsi (Mayo Clinic)H-Index: 9
#2Andras Khoor (Mayo Clinic)H-Index: 20
Last. Isabel Mira-Avendano (Mayo Clinic)H-Index: 4
view all 4 authors...
Abstract A 40-year-old woman (a nonsmoker) with history of idiopathic thrombocytopenic purpura and a platelet count > 90,000 cells/μL without specific medication was referred to pulmonary clinic for evaluation of multiple pulmonary nodules. The patient presented to an outside hospital with fatigue, lack of energy, and dyspnea on exertion for 2 years. She denied fever, cough, chest pain, or weight loss. An initial chest radiograph showed bilateral multiple pulmonary nodules. A chest CT scan revea...
8 CitationsSource
Introduction Despite the tremendous number of malignant epithelial lung neoplasms worldwide, benign epithelial tumors and tumor-like lesions are rare. Endobronchial and peripheral parenchymal lesions are both seen. While voluminous epidemiological and molecular information is lacking, lesional morphologies are well described. Recognizing these lesions as benign is of paramount importance. Bronchial inflammatory polyps Introduction Although the upper respiratory tract is a common location for inf...
#1Erin Chapman (UBC: University of British Columbia)H-Index: 4
#2Allen M. GownH-Index: 77
Last. Andrew ChurgH-Index: 93
view all 4 authors...
Pulmonary hyalinizing granulomas (PHGs) are unusual fibrosclerotic inflammatory lung lesions. The organ-based manifestations of the recently defined IgG4-related sclerosing disease typically show dense fibrosis and heavy lymphoplasmacytic infiltrates. IgG4-related sclerosing disease is also defined
19 CitationsSource
#1Guilherme D'Andréa Saba Arruda (UNIFESP: Federal University of São Paulo)H-Index: 1
#2Paulo César Ribeiro de Carvalho (UNIFESP: Federal University of São Paulo)H-Index: 1
Last. Felipe Shigueo Passos Tozaki (UNIFESP: Federal University of São Paulo)H-Index: 1
view all 6 authors...
We report the case of a 61-year-old male patient who underwent surgical excision of a lung mass for anatomopathological study. The patient had previously presented with fever, dry cough, and chest pain, together with lung masses detected by chest X-ray, and had undergone thoracotomy for diagnostic investigation on two occasions (1976 and 1981), although a conclusive diagnosis had not been made. A CT scan of the chest revealed large masses with areas of calcification in both lung fields. The anat...
3 CitationsSource
#1Chi-Tun Lien (KMU: Kaohsiung Medical University)H-Index: 2
#2Chih-Jen YangH-Index: 2
Last. Ming-Shyan HuangH-Index: 2
view all 5 authors...
: Pulmonary hyalinizing granuloma (PHG) is a rare disease characterized by multiple bilateral pulmonary nodules of uncertain etiology. We describe a 71-year-old female patient with thyroid papillary carcinoma in whom bilateral pulmonary nodules were found during a routine chest radiography examination. Subsequent fluorodeoxyglucose positron emission tomography/computed tomography scan gave the impression of multiple pulmonary metastases based on high maximum standardized uptake value. She underw...
6 CitationsSource