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Histopathological Heterogeneity in Pulmonary Hyalinizing Granulomas: A Case Report.

Takuma Katano¹, Etsuro Yamaguchi¹, Toyonori Tsuzuki²

¹Department of Respiratory Medicine and Allergology Aichi Medical University Nagakute Japan.

Respirology Case Reports

|March 11, 2026

Summary

Pulmonary hyalinizing granuloma (PHG) is a rare lung disease. This case highlights significant inter-lesional histopathological differences in PHG within a single patient.

Keywords:

lung nodule mucosa‐associated lymphoid tissue lymphoma pulmonary hyalinizing granuloma

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Area of Science:

Pulmonology
Pathology
Oncology

Background:

Pulmonary hyalinizing granuloma (PHG) is a rare, benign lung condition.
PHG typically exhibits slow progression or stability.

Purpose of the Study:

To report a unique case of multiple PHG lesions in a single patient.
To investigate inter-lesional histopathological variations in PHG.

Main Methods:

Surgical resection of multiple PHG lesions.
Detailed histopathological examination of resected specimens.
Immunohistochemistry and light-chain analysis for differential diagnosis.

Main Results:

First resection confirmed PHG with typical features.
Second resection, three years later, showed PHG with increased lymphoid follicles.
Immunohistochemistry ruled out mucosa-associated lymphoid tissue lymphoma, confirming a reactive process.

Conclusions:

PHG can exhibit significant inter-lesional histopathological differences within the same patient.
Increased lymphoid infiltration in PHG may mimic lymphoma but can represent a reactive process.