CTICasesPulmonary Hyalinizing Granuloma
Imaging findings
Chest radiograph and CT in an alcoholic patient show confluent, bilateral hilum-centered consolidative masses and multiple discrete pulmonary nodules, mimicking sarcoidosis. There is associated hilar and mediastinal lymphadenopathy and mild punctate calcification. Core needle biopsy of a nodule confirms pulmonary hyalinizing granuloma (PHG), showing whorled lamellar collagen with sparse lymphocytic infiltrate.
Key takeaways
Pulmonary hyalinizing granuloma (PHG) is a rare, benign, chronic inflammatory disease characterized by the formation of solitary or multiple parenchymal nodules composed of hyalinized collagen. It represents an abnormal immune response to prior infections (e.g., histoplasmosis, tuberculosis) or autoimmune processes. PHG can coexist with retroperitoneal fibrosis, sclerosing mediastinitis, or IgG4-related disease, and is treated with corticosteroids if symptomatic.
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