Radiology–Pathology Conference: pulmonary hyalinizing granuloma associated with lupus-like anticoagulant and Morvan's Syndrome

Winger, David; Spiegler, Peter; Trow, Terence K.; Goyal, Amit; Yu, Huiying; Yung, Elizabeth; Katz, Douglas S.

doi:10.1016/j.clinimag.2007.03.007

Cited by 21 publications

(25 citation statements)

References 22 publications

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“…8,14,15,23 Case reports describe PHG occurring in patients with other autoimmune diseases. 13,21 With this case, we have evidence that at least some cases of PHG are manifestations of IgG4 disease, although whether PHG always represents IgG4 disease remains to be determined.…”

Section: Discussionmentioning

confidence: 94%

Pulmonary Hyalinizing Granuloma With Associated Elevation in Serum and Tissue IgG4 Occurring in a Patient With a History of Sarcoidosis

Chapman

Gown²,

Mazziotta

et al. 2012

American Journal of Surgical Pathology

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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 by increased serum IgG4 levels and increased tissue levels of IgG4-positive plasma cells. The morphologic features of PHG overlap with those seen in IgG4-related sclerosing disease, and this suggests that PHG may be a form of IgG4-related sclerosing disease. We present a case of a 51-year-old man with a history of sarcoidosis who presented with slowly enlarging pulmonary nodules. Histologic evaluation of one of the nodules yielded a diagnosis of PHG. Further investigation demonstrated both elevated serum IgG4 and elevated tissue IgG4-positive plasma cells in the PHG. In previous reports, lesions that are now considered part of IgG4-related sclerosing disease were documented in patients also diagnosed with PHG, although these reports date from before the description of IgG4 sclerosing disease. This case provides the first definitive evidence that PHG is part of the spectrum of IgG4-related sclerosing disease.

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Section: Discussionmentioning

confidence: 94%

Pulmonary Hyalinizing Granuloma With Associated Elevation in Serum and Tissue IgG4 Occurring in a Patient With a History of Sarcoidosis

Chapman

Gown²,

Mazziotta

et al. 2012

American Journal of Surgical Pathology

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“…[5] No gender or racial predilection has been shown. PHG often presents with vague chest symptoms or is found on incidental chest imaging, as in this case.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary Hyalinizing Granuloma Associated with Idiopathic Thrombocytopenic Purpura

Coleman

Nassar

McComb

2014

Journal of Clinical Imaging Science

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Pulmonary hyalinizing granuloma (PHG) is a rare, benign lung disease of unknown etiology. It manifests as discrete, rounded nodules within the lung parenchyma. A 39-year-old woman presented for investigation after pulmonary nodules were found incidentally. Chest computed tomography showed multiple, discrete, non-enhancing pulmonary nodules bilaterally. Positron emission tomography (PET) was negative. Biopsy demonstrated a non-specific lymphoplasmacytic infiltrate. Open resection yielded two nodules consistent with hyalinizing granulomas. The differential for multiple pulmonary nodules is broad. PET scan can help rule out metastatic disease, although some cancers are not hypermetabolic on PET. Furthermore, some non-malignant conditions, including hyalinizing granuloma, can show increased activity on PET. PHG should be included in the differential of multiple pulmonary nodules, especially if nodule stability can be demonstrated and/or needle biopsies are non-diagnostic. Associated immune-mediated conditions, such as idiopathic thrombocytopenic purpura (ITP) in our patient, may also favor HG. In this case report we find an association between PHG and ITP.

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“…The mean age of person afflicted with the disease is 44 years [1] and there is no sex predilection or race predominance [2, 6]. The clinical symptoms of PHG are mild and nonspecific, and may include cough, fever, fatigue, dyspnea, pleuritic chest pain, sinusitis, and pharyngitis.…”

Section: Discussionmentioning

confidence: 99%

“…Pulmonary hyalinizing granuloma (PHG) is a rare benign lung disease characterized by fibrosing nodules, consisting of either unilateral or bilateral central whorled deposits of lamellar collagen hyaline [1]. The exact etiology of this condition is unknown [2], although an exaggerated immune response to the antigenic stimuli by infection or autoimmune process has been suggested [3, 4].…”

Section: Introductionmentioning

confidence: 99%

Hyalinizing Granuloma: An Unusual Case of a Pulmonary Mass

Brandão

Marchiori

Zanetti

et al. 2010

Case Reports in Medicine

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We describe the case of pulmonary hyalinizing granuloma in a 34-year-old asymptomatic man who presented with a pulmonary nodule apparent by chest radiography and computed tomography (CT). He had a history of previous treatment for tuberculosis. His laboratory data were normal. Bronchoscopy and CT-guided percutaneous transthoracic fine needle aspiration cytology were inconclusive. The diagnosis was revealed after the histopathological examination of an open lung biopsy.

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Radiology–Pathology Conference: pulmonary hyalinizing granuloma associated with lupus-like anticoagulant and Morvan's Syndrome

Cited by 21 publications

References 22 publications

Pulmonary Hyalinizing Granuloma With Associated Elevation in Serum and Tissue IgG4 Occurring in a Patient With a History of Sarcoidosis

Pulmonary Hyalinizing Granuloma With Associated Elevation in Serum and Tissue IgG4 Occurring in a Patient With a History of Sarcoidosis

Pulmonary Hyalinizing Granuloma Associated with Idiopathic Thrombocytopenic Purpura

Hyalinizing Granuloma: An Unusual Case of a Pulmonary Mass

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