Pulmonary hyalinizing granuloma: a cause of pulmonary nodules

The radiological and histological appearance of pulmonary hyalinizing granuloma (PHG) and its pathogenesis are described. The histological features bear a striking resemblance to fibrosing mediastinitis. Patients present clinically with nonspecific respiratory or general symptoms. Slowly growing solitary or, more often, multiple nodules are found on radiographs of the chest, suggesting neoplastic disease. Four patients with PHG are described. Four patients with PHG are described. One had lesions in the kidneys that were pathologically identical to those of PHG. There is no clear etiology for this disease, but from the cases reported here and those reported previously it is postulated that diverse etiologic factors might lead to a common immunological response. Inflammatory agents such as tubercle bacilli or fungal organisms (e.g., Histoplasma), or a collagen or autoimmune disease may act as trigger mechanisms for the induction of PHG.