Pulmonary Hyalinising Granuloma:a Case Report And Literature Review

Objective:To analyse the clinical feature of pulmonary hyalinizing granuloma in order to expand the understanding of the disease.Methods:This paper would retrospectively analyze the clinical materials of one patient with pulmonary hyalinizing granuloma,which was proven histopathologically in the First Affiliated Hospital of Guangxi Medical University.The the clinical manifestation,latoratory study,imaging data,pathology,treatment and prognosis will be analyzed together with the domestic an international literatures.Results:(1)The female patient was 73-year-old,whose main symptoms was cough, mild dyspnea, dull to percussion in the right lung.ESR, hypersensitive C-reactive protein,RF was elevated,anti-Ro-52 weekly positive.Chest CT revealed pleural effusion in the right side and a nodules with calcification in the right middle lobe.The pathological diagnosis confirmed PHG. (2)The results of literature review:From the PUB MED and other databases retrieval from 1977 to December,2015 cases with PHG at home and abroad,a preliminar retrieval with 83 references,according to the pathological diagnosis,a total of 25 cases had been reported in accordance with the inclusive criteriam,including 16 male cases, 9 female cases,the average age was (47.28+17.859) years.The most common clinical manifestations were mild cough,dyspnea,chest pain,occasionally with involvement of pleura.19 routine laoratory study,more showed ESR, C-reactive protein elevated.Autoantibody profile would be positive.25 imaging datas,gave priority to with bilateral lung nodules or solitary lesions,unusual findings including spicule sign,pleural indentation, pleural effusion.Histopathology all showed PHG In 4 patients with the treatment of steroid the symptoms were improve.Follow-up information was obtain in 12 of 25 case.All patients with solitary lesions were without evidence of disease.In 7 people with bilateral disease,the nodules remained stable in size radiographically,while in 1 people the lessions showed progressive enlargement.Conclusions:(1)PHG is a rare etiology of lung nodules.It can occur in all ages. It happens in male more than in female.(2)PHG has insidious onset. The most common clinical manifestations were mild cough,dyspnea,chest pain,occasionally with involvement of pleura.(3)Chest radiographs usually demonstrate bilateral lung nodules or solitary lesions,unusual findings including spicule sign,pleural indentation.(4)PHG is diagnosed with the lesions characteristically consisted of central concentric hyaline lamellae.(5)the surgical removal and steroid are the main treatment.The prognosis of PHG is favourable.