Pulmonary Hyalinizing Granuloma Mimicking Metastatic Lung Cancer

Abstract

Pulmonary hyalinizing granuloma is a very rare benign condition, which usually manifests as solitary and sometimes as multiple pulmonary nodules. Deposition of immune complexes in the lung parenchyma due to hypersensitivity reactions is implicated in the etiology of pulmonary hyalinizing granuloma. A 59-year-old female patient who presented to our clinic with complaints of chest pain and cough had bilateral, multiple, and rounded lesions with regular margins suggesting metastatic lung disease. A transthoracic needle biopsy of the nodule was performed in the left pulmonary anterior segment. Biopsy showed no malignancy. Since no diagnosis was made by the biopsy, the patient underwent a video-assisted thoracic surgery. The wedge biopsy reported pulmonary hyalinizing granuloma. We aimed to present the diagnosis and treatment stages of our patient who was diagnosed with pulmonary hyalinizing granuloma in the light of literature review.

Pulmonary hyalinising granuloma: a rare and elusive cause of multiple lung nodules

“…Despite its benign nature, it can often present similarly to metastatic disease3 5 and thus patients can undergo extensive investigation to seek a definitive diagnosis. There is often diagnostic uncertainty around PHG, and the existing literature have indicated that a definitive diagnosis is usually gained only after surgical intervention as in our patient 4 7 8.…”

“…Despite its benign nature, it can often present similarly to metastatic disease3 5 and thus patients undergo extensive investigation to seek a definitive diagnosis. As the investigations working up this disease are not without their risks and complications, it is important for clinicians to reflect on an increasingly recognised cause of lung nodules which can lead patients into having a long and invasive course of treatment and rehabilitation.…”

A first case report of pulmonary hyalinizing granuloma associated with immunoglobulin A nephropathy

“…[ 3 ] Patients usually present with symptoms of cough, dyspnea, and chest pain. [ 4 ] About 25% of patients are asymptomatic. [ 5 , 6 ] If the esophagus is compressed by a tumor, dysphagia can develop.…”

Pulmonary Hyalinizing Granuloma: A Case Report

“…Final conclusive diagnosis is based on histopathological analysis of the nodule biopsy specimen [8]. PHG is a benign, sometimes recurrent condition, with no predilection for gender that is predominantly multinodular, as in the case reported.…”