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Pulmonary hyalinizing granuloma with hydronephrosis.
Seiji Hashimoto1, Wataru Fujii, Tatsurou Takahashi
1Department of Nephrology, Sapporo City General Hospital, Hokkaido.
Internal Medicine (Tokyo, Japan)
|July 24, 2002
Summary
Pulmonary hyalinizing granuloma (PHG) can manifest with systemic complications, including retroperitoneal fibrosis. Prompt steroid treatment effectively resolved these symptoms and reversed laboratory abnormalities.
Area of Science:
- Pulmonology
- Nephrology
- Pathology
Background:
- Pulmonary hyalinizing granuloma (PHG) is a rare, benign lung disorder.
- Diagnosis can be challenging, often requiring surgical resection for definitive pathology.
- Systemic manifestations of PHG are uncommon but reported.
Observation:
- A 49-year-old male presented with bilateral chest masses initially diagnosed as PHG.
- Post-surgical follow-up revealed persistent low-grade fever and declining renal function.
- Imaging demonstrated bilateral hydronephrosis and retroperitoneal fibrosis.
Findings:
- Laboratory tests showed polyclonal hypergammaglobulinemia.
- The clinical presentation and imaging were consistent with retroperitoneal fibrosis secondary to PHG.
- Steroid therapy led to complete resolution of fever, renal dysfunction, and imaging abnormalities.
Implications:
- This case highlights the potential for PHG to cause extrathoracic complications.
- It underscores the importance of considering systemic involvement in PHG patients.
- Successful management with corticosteroids suggests an immune-mediated component in PHG-associated systemic disease.