Solitary pulmonary hyalinising granuloma: a rare cause of pulmonary nodule

Abstract

A pulmonary nodule is a common incidental finding on chest imaging, which includes a wide variety of differential diagnosis. Pulmonary hyalinising granuloma is a rare disease aetiology of pulmonary nodule(s). We report a 74-year-old female who was referred to the respiratory clinic with incidental finding of a solitary pulmonary nodule on chest X-ray. CT confirmed the presence of a 1.2 cm solitary pulmonary nodule in the left upper lobe with no lymphadenopathy. The patient underwent wedge resection, and histopathological examination of the lesion confirmed pulmonary hyalinising granuloma. In most previously reported cases, patients had multiple lesions on chest radiography. Solitary pulmonary lesion is an uncommon presentation of this clinical entity and only a few cases have been reported in the literature.

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. Recognising the difficulty in making a diagnosis also impacts on a patient’s emotional well-being with, potential for complications from invasive investigations and uncertainty over a potential lung cancer diagnosis, is also important.…”

“…PHG, though rare, is a recognised cause of benign lung nodules. The disease was first described by Engleman et al in 1977,6 it can present at any age,1 typically with non-specific symptoms and has an excellent prognosis2 3 with no malignant potential 4. The aetiology of PHG is not well understood.…”

“…Pulmonary hyalinising granuloma (PHG) is a rare cause of lung nodules, which can present at any age in adulthood 1. PHG typically presents with non-specific symptoms and has excellent prognosis2 3 without malignant potential 4…”