Goto Madoka, Ichikawa Yasuhisa, Tsubouchi Hideki, Fukumoto Koichi, Mori Shoichi
Thoracic Surgery, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, Nagoya, JPN.
Cureus. 2025 Sep 15;17(9):e92407. doi: 10.7759/cureus.92407. eCollection 2025 Sep.
Pulmonary hyalinizing granuloma is a rare, benign tumor that arises from the pulmonary parenchyma and is difficult to diagnose preoperatively and intraoperatively. These typically present on chest computed tomography images as gradually enlarging, bilateral multiple pulmonary nodules. Herein, we report two cases wherein intraoperative frozen section analysis suggested fibrosis, but histopathological examination of the surgical specimens confirmed the diagnosis of pulmonary hyalinizing granuloma. Both patients were females in their 60s with incidental chest computed tomography findings of bilateral multiple pulmonary nodules. Video-assisted thoracoscopic lung biopsy was performed, with the intraoperative frozen section analysis suggesting fibrosis. Pathological examination revealed a dense proliferation of hyalinized collagen fiber bundles, with inflammatory cell infiltration observed around the nodules, confirming a diagnosis of pulmonary hyalinizing granuloma. No nodule enlargement or emergence of new nodules was observed postoperatively after 12 months in Case 1 and 11 months in Case 2. The diagnosis of pulmonary hyalinizing granuloma is challenging both preoperatively and intraoperatively. Obtaining permanent histological specimens through lung biopsy is essential to make a definitive diagnosis.
肺透明变性肉芽肿是一种罕见的良性肿瘤，起源于肺实质，术前和术中均难以诊断。这些病变在胸部计算机断层扫描图像上通常表现为逐渐增大的双侧多发肺结节。在此，我们报告两例病例，术中冰冻切片分析提示为纤维化，但手术标本的组织病理学检查确诊为肺透明变性肉芽肿。两名患者均为60多岁女性，胸部计算机断层扫描偶然发现双侧多发肺结节。进行了电视辅助胸腔镜肺活检，术中冰冻切片分析提示为纤维化。病理检查显示透明变性的胶原纤维束密集增生，结节周围可见炎性细胞浸润，确诊为肺透明变性肉芽肿。病例1术后12个月、病例2术后11个月均未观察到结节增大或出现新的结节。肺透明变性肉芽肿的诊断在术前和术中都具有挑战性。通过肺活检获取永久性组织标本对于明确诊断至关重要。
