PMC6039758_01
CT image showing well circumscribed bilateral pulmonary nodules.
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Subsequent CT showed bilateral pulmonary nodules measuring up to 2cm in the upper and mid-zones, diffuse adrenal swelling and renal cysts (Fig. 1).
PET- CT slice at the equivalent level showing bilateral FDG - avid pulmonary nodules.
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A PET-CT at this time showed multiple FDG avid nodules with maximum standardised uptake value (SUV) of 6.9 in both lungs (Fig. 2), alongside several FDG negative nodules in both lungs and an FDG avid portocaval nodule.
A pulmonary hyalinising granuloma comprising of a well circumscribed mass made up of thick collagen bundles interspersed by a patchy non-specific chronic inflammatory cell infiltrate (H&E stain, x40).
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The result showed a discrete nodule comprising bundles of hyalinising collagen interspersed by varying numbers of plasma cells, indicative of a pulmonary hyalinising granuloma (Fig. 3).