[Pulmonary hyalinizing granuloma].

Area of Science:

• Pulmonology
• Pathology
• Oncology

Background:

• Pulmonary hyalinizing granuloma (PHG) is a rare, benign lung condition.
• PHG can present with infiltrative or nodular lesions, often mimicking malignant lung disease.
• The etiology of PHG remains largely unknown, with theories suggesting an immune response to an antigen.

Observation:

• A 63-year-old patient presented with dyspnea and significant weight loss.
• CT scans revealed a destructive, infiltrative pulmonary process with pleural thickening.
• Initial biopsies were inconclusive, and the condition progressed, leading to a left-sided pleuropneumonectomy.

Findings:

• Histological examination post-surgery revealed DIP-like infiltrations, a histiocytic reaction, and hyaline granulomas.
• This case represents a rare instance of rapid PHG progression leading to complete functional loss of one lung.
• No known associated conditions like infections, lymphomas, amyloidosis, or IgG4-related disease were identified.

Implications:

• The case highlights the aggressive potential of PHG, contrasting with its generally benign prognosis.
• It underscores the diagnostic challenges, as PHG can be mistaken for lung cancer.
• While conservative management or nodule resection is typical, this case suggests extensive surgery may be rarely required for rapidly progressing PHG.