Open AccessPulmonary hyalinising granuloma: a rare and elusive cause of multiple lung nodules
Author(s) -
Ivan Tang,
Alastair Moore,
Eve Fryer,
Annemarie Sykes
Publication year - 2020
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr-2019-233327
Subject(s) - medicine , malignancy , radiology , lung cancer , wedge resection , granuloma , biopsy , lung , positron emission tomography , lung biopsy , fluorodeoxyglucose , differential diagnosis , pathology , resection , surgery
A 72-year-old woman was referred with incidentally detected multiple lung nodules, one of which was identified as 18 F-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.