Immunologic Research

, Volume 65, Issue 1, pp 375–385 | Cite as

Pulmonary hyalinizing granuloma: a multicenter study of 5 new cases and review of the 135 cases of the literature

  • Raphael Lhote
  • Julien Haroche
  • Loïc Duron
  • Nicolas Girard
  • Marie Pierre Lafourcade
  • Michel Martin
  • Hugues Begueret
  • André Taytard
  • Frédérique Capron
  • Philippe Grenier
  • Jean Charles Piette
  • Fleur Cohen-Aubart
  • Zahir Amoura
Mechanism in Autoimmunity


Pulmonary hyalinizing granuloma (PHG) is a rare disease characterized by single or multiple benign lung nodules mimicking lung neoplasma. Histologic analysis reveals homogenous hyaline lamellae, usually surrounded by collection of plasma cells, lymphocytes and histiocytes in a perivascular distribution. The clinical and radiological findings have been described in small series, but the long-term outcomes have rarely been reported. The objectives were to describe the clinical, radiological and outcomes of PHG in new cases and through a literature review. Patients with PHG were found by a multicenter search among French departments of internal medicine, pulmonology and anatomo-pathology. Review of the literature was made through the National Library of Medicine’s MEDLINE database using keywords “hyalinizing granuloma.” Five news cases and 135 cases of the literature were found. There were 82 men and 57 women, mean age at the diagnosis 44.6 years (15–83). Patients were frequently asymptomatic (n = 39, 27.4 %). The nodule was unique in 37 cases (28.9 %) and multiple in 91 cases (71.1 %). 18FDG PET scan revealed hypermetabolism of the nodule in 9/15 cases (60 %). A systemic disease was associated in 65 cases (mainly mediastinal and retroperitoneal fibrosis, autoimmune, tumoral or infectious disease or thromboembolism). The outcomes were evaluated in 73 patients when follow-up was available: 14 patients had a surgical resection of the nodule. Forty-five patients did not receive any immunosuppressive drug. Among these patients, 2 improved, 29 were stable and 14 worsened. Corticosteroids were used as a monotherapy in 19 patients and led to radiological improvement in 8 cases, stabilization in 8 cases and worsening in 3 cases. Five patients were treated with corticosteroids and at least one immunosuppressive drug and 4 patients improved. PHG is a rare benign disease, mimicking lung neoplasma, frequently associated with systemic diseases.


Hyalinizing granuloma Lung nodule 18FDG PET scan 



Broncho-alveolar lavage

CT scan

Computerized tomography scanner


Forced expiratory volume in one second


Forced vital capacity


Hepatitis B virus


Hepatitis C virus


Human immunodeficiency virus


Mucosa-associated lymphoid tissue


Pulmonary hyalinizing granuloma


Standard uptake value


18 Fluorodeoxyglucose positron emission tomography



Mehdi Gharbi, Harika Salepcioglu, Toshikado Kaneta, Yojiro Shibata, Young Jiang carried out the translation of articles and bibliography search.

Compliance with ethical standards

Conflict of interest

The authors have no conflicts of interests.


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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Raphael Lhote
    • 1
  • Julien Haroche
    • 1
    • 2
  • Loïc Duron
    • 1
  • Nicolas Girard
    • 3
  • Marie Pierre Lafourcade
    • 4
  • Michel Martin
    • 4
  • Hugues Begueret
    • 5
  • André Taytard
    • 6
  • Frédérique Capron
    • 2
    • 7
  • Philippe Grenier
    • 2
    • 8
  • Jean Charles Piette
    • 1
    • 2
  • Fleur Cohen-Aubart
    • 1
    • 2
  • Zahir Amoura
    • 1
    • 2
  1. 1.Service de Médecine Interne 2, Centre National de Référence Maladies auto-immunes Systémiques Rares, AP-HPGroupe Hospitalier Pitié-SalpêtrièreParis Cedex 13France
  2. 2.Université Pierre et Marie Curie, Paris VISorbonnes UniversitésParisFrance
  3. 3.Service de Pneumologie, Centre National de Référence des Maladies Pulmonaires Rares Centre Expert National associé du Réseau RYTHMIC Tumeurs Thymiques et CancerHôpital Louis PradelLyonFrance
  4. 4.Service de PneumologieCentre Hospitalier d’AngoulêmeAngoulêmeFrance
  5. 5.Service d’Anatomo-PathologieCentre Hospitalier de PessacPessacFrance
  6. 6.Service de PneumologieCentre Hospitalier de PessacPessacFrance
  7. 7.Service d’Anatomo-pathologie, AP-HPGroupe Hospitalier Pitié SalpêtrièreParisFrance
  8. 8.Service de Radiologie, AP-HPGroupe Hospitalier Pitié SalpêtrièreParisFrance

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