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 in the kidneys that were pathologically identical to those of PHG. There is no clear etiology for this disease, but from the cases reported here and those reported previously it is postulated that diverse etiologic factors might lead to a common immunological response. Inflammatory agents such as tubercle bacilli or fungal organisms (e.g., Histoplasma), or a collagen or autoimmune disease may act as trigger mechanisms for the induction of PHG.
A two-way television network using the Canadian satellite ANIK-B was utilized to transmit radiographic images from Northern Quebec to Montreal. The accuracy of the radiologist's interpretation and his satisfaction with the TV system were studied using a series of 67 preselected cases and 425 current clinical cases. The four participating radiologists gave correct TV interpretations in 81% of the 39 selected cases presented at the beginning of the experiment. This value reached 94% for the other 28 selected cases presented after three months of regular use of the TV system. With current clinical cases, the agreement between TV and direct interpretations was 93%. Although magnification was available, correct identification of very small lesions proved to be the major source of error. On the whole, the radiologists were satisfied with the TV system.
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