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Case report
Pulmonary hyalinising granuloma: a rare and elusive cause of multiple lung nodules
  1. Ivan Tang1,
  2. Alastair J Moore2,
  3. Eve Fryer3 and
  4. Annemarie Sykes2
  1. 1Intensive Care and Respiratory Medicine Higher Specialty Trainee, Health Education Thames Valley - HETV, Oxford, Oxfordshire, UK
  2. 2Oxford Centre for Respiratory Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, Oxfordshire, UK
  3. 3Cellular Pathology, John Radcliffe Hospital, Oxford, Oxfordshire, UK
  1. Correspondence to Dr Ivan Tang; ivan.tang09{at}doctors.org.uk

Abstract

A 72-year-old woman was referred with incidentally detected multiple lung nodules, one of which was identified as 18F-fluorodeoxyglucose (FDG)-avid on positron emission tomography. Extensive workup followed, including numerous radiographs, surveillance scans and a CT-guided biopsy which demonstrated chronic inflammation only. Following a wedge-resection, a diagnosis of pulmonary hyalinising granuloma (PHG) was made. PHG is a cause of FDG-avid single or multiple pulmonary nodules and can mimic lung cancer or metastatic disease radiologically. The diagnosis is often difficult to make with minimally invasive techniques such as needle-guided biopsies which do not tend to yield the diagnosis and requires surgical resection for definitive diagnosis and exclusion of malignancy.

  • lung cancer (oncology)
  • respiratory medicine
  • bronchopulmonary dysplasia
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Footnotes

  • Contributors IT wrote the first draft and subsequent revision. AJM, EF and AS contributed to the clinical care of the patient and approved the drafts.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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