18 F FDG PET-CT Scan Findings in a Rare Case of Pulmonary Hyalinising Granuloma

Abstract

Pulmonary hyalinising granuloma (PHG) is a benign lung disease. It is a rare disease of unknown aetiology. Less than 150 cases are reported. Its aetiology has not been established but the underlying cause is thought to be the deposition of an immune complex in lung parenchyma or autoimmune process. It usually presents as solitary or multiple lung nodules. PHG has a good prognosis. Solitary lesions are treated by resection and multiple lesions are treated with immunosuppressive drugs with variable responses. Here, we report a case of a 68-year-old female who presented with two episodes of haemoptysis. On investigation, chest computed tomography (CT) reveals multiple lung nodules on both sides, 18 F fluorodeoxyglucose (FDG) positron emission tomography and CT scan reveal mildly FDG avid and non-FDG avid subpleural and parenchymal nodular lesions of varying sizes with calcification noted scattered diffusely in both lung fields. Pathology findings are suggestive of fibrocollagenous tissue with tiny foci of epithelial cells arranged as papillae, cuboid cells with minimal atypia, mitosis, and necrosis not seen and no lymphoid tissue seen, suggestive of PHG.