Archive of Old Cases
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- Archive of Old Cases
- 2012
Case No : 753 Date 2012-04-02
- Courtesy of Gongyoung Jin / Chonbuk National University Hospital
- Age/Sex 68 / F
- Chief Complaintfor health screen
Discussion
Diagnosis With Brief Discussion
- Diagnosis
- Nodular lymphoid hyperplasia
- Radiologic Findings
- Chest radiography show suspicious nodular opacity in the right cardiophrenic angle. Non-contrast chest CT with mediastinal setting shows 2 cm sized well-defined nodule with soft tissue density and contrast-enhanced CT shows homogenous enhancement. Chest CT with lung setting shows multiple variable sized subpleural nodules. On pathologic findings, reactive lymphoid follicles (arrows) and many lymphoid cells are embedded in collagenous backgroud. They are obliterates the underlying lung architecture. Immunohistochemical stains show a reactive pattern of B and T cells. Lymphocytes infiltrated into bronchial epithelial cells are CD3 positive.
- Brief Review
- Pulmonary Nodular lymphoid hyperplasia (NLH) is one of the pulmonary lymphoproliferative disorders. NLH was first described by Kradin and Mark as one or more benign nodules or localized lung infiltrates comprised of reactive lymphoid proliferation. NLH was initially described as pseudolymphoma and tend to misdiagnosed preoperatively with adenocarcinoma. It is important to differentiate pulmonary NLH from pulmonary MALT-type lymphoma. The most common radiographic finding with PNLH is a solitary pulmonary nodule, typically measuring 2 to 4 cm in diameter. On CT, NLH shows smooth, lobulated, or, less commonly spiculated margin. On contrast-enhanced CT, NLH shows various enhancement patterns. The prognosis for PNLH might be excellent.
- References
- 1. Kradin RL, Mark EJ. Benign lymphoid disorders of the lung, with a theory regarding their development. Hum Pathol 14: 857-867, 1983.
2. Abbondanzo SL, Rush W, Bijwaard KE, Koss MN. Nodular lymphoid hyperplasia of the lung: a clinicopathologic study of 14 cases. Am J Surg Pathol 24: 587-597, 2000.
3. Karube Y, Chida M, Honma K, Araki O, Kobayashi S, Miyoshi S. Nodular lymphoid hyperplasia: rare case of lymphoproliferative disease in the lung. Gen Thorac Cardiovasc Surg. 2009 Jun;57(6):324-7. Epub 2009 Jun 17.
- Keywords
- lung, lymphoproliferative disease,
No. of Applicants : 95
- ▶ Correct Answer : 6/95, 6.3%
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- - Oita University, Faculty of Medicine , Japan Fumito Okada
- - Kurashiki Seijin-byo Center , Japan Akihiro Tada
- - NATIONAL GUARD HEALTH SERVICES , Saudi Arabia MOHAMED AHAMED
- - China Medical University ,Taiwan,R.O.C. , Taiwan Jun Jun Yeh
- - Korea university , Korea (South) Kun Woo Kang
- - Private sector , Greece Vasilios Tzilas
- ▶ Correct Answer as Differential Diagnosis : 10/95, 10.5%
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- - Diskapi Yildirim Beyazit Hospital, Ankara , Turkey Meric Tuzun
- - Heart Center Pontica , Bulgaria VLADISLAV RUSINOV
- - Medical College Chest Hospital,Thrissur,Kerala , India Raveendran TK
- - Onomichi municipal hospital , Japan Ryotaro Kishi
- - Kyung Hee University Medical center , Korea (South) Myung You
- - Asan medical center , Korea (South) Sang Young Oh
- - Deptt of Radiodiagnosis & Imaging, PGIMER chandigarh , India Ram Galwa
- - All India Institute of medical sciences , India Justin Moses
- - fmmc , India subas kandimalla
- - Seoul St Mary Hospital , Korea (South) Chae Lim
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