Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2021 Oct 9;16(1):289.
doi: 10.1186/s13019-021-01672-y.

Pulmonary nodular lymphoid hyperplasia in a 53-year-old man with malignant sign: a case report

Zhen Yang  1 , Lianshuang Wei  2 , Xu Li  1 , Xin Liu  3
Affiliations
Case Reports

Pulmonary nodular lymphoid hyperplasia in a 53-year-old man with malignant sign: a case report

Zhen Yang et al. J Cardiothorac Surg. .

Abstract

Background: Pulmonary nodular lymphoid hyperplasia (PNLH) is a rare benign illness. Due to atypical clinical and radiographic presentations, diagnosis largely depends on postoperative pathological examination. Thus, preoperative misdiagnosis is often occurred.

Case presentation: We present a case of asymptomatic PNLH that was seen as ground-glass opacity (GGO) on computed tomography (CT). After 3-year observation, the diagnosis tends to adenocarcinoma owing to increasing density of the node and vessel convergence sign, which were signs of malignancy. Video-assisted segmentectomy (S10) was carried out. Histopathologic examination of postoperative specimen showed follicular lymphoid hyperplasia with interfollicular lymphoplasmacytosis, consistent with PNLH. The follow-up chest CT images showed no recurrence or metastasis.

Conclusion: Although it is a benign disease, PNLH can exhibit malignant signs in the imaging examinations, which could lead to misdiagnosis. This reminds us of the uncertainty between imaging findings and diagnosis. The diagnosis depends on postoperative pathological examination. Volume doubling time is a potential parameter to differentiate PNLH from lung cancer.

Keywords: Case report; Malignant signs; Misdiagnosis; Pulmonary nodular lymphoid hyperplasia; Volume doubling time.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The CT scan of the patient. a Initial CT scan performed in July 2017. b Follow-up CT scan performed in November 2018. c Follow-up CT scan performed March 2019. d The three-dimensional reconstruction of CT scan performed in March 2019
Fig. 2
Fig. 2
Histopathologic and immunohistochemical result. a Reactive germinal centers. b Germinal center cells. c A mixture of polyclonal B, T lymphocytes and plasma cells. d Bcl-6 immunostaining. e CD3 immunostaining. f CD60 immunostaining. g CD45R0 immunostaining. h Ki67 immunostaining
See this image and copyright information in PMC

References

    1. Sim J, Koh HH, Choi S, Chu J, Kim TS, Kim H, Han J. Pulmonary nodular lymphoid hyperplasia with mass-formation: clinicopathologic characteristics of nine cases and review of the literature. J Pathol Transl Med. 2018;52(4):211–218. doi: 10.4132/jptm.2018.04.27. - DOI - PMC - PubMed
    1. Fang L, Xu J, Wang L, He Z, Lv W, Hu J. Pulmonary nodular lymphoid hyperplasia: a rare benign disease with malignant mask. Ann Transl Med. 2019;7(4):43. doi: 10.21037/atm.2018.12.59. - DOI - PMC - PubMed
    1. Yell M, Rosado FG. Pulmonary nodular lymphoid hyperplasia. Arch Pathol Lab Med. 2019;143(8):1149–1153. doi: 10.5858/arpa.2018-0188-RS. - DOI - PubMed
    1. Bégueret H, Vergier B, Parrens M, Parrens M, Lehours P, Laurent P, Vernejoux J, Dubus P, Velly J, Mégraud F, Taytard A, Merlio J, Mascarel A. Primary lung small B-celllymphoma versus lymphoid hyperplasia: evaluation of diagnostic criteria in 26cases. Am J Surg Pathol. 2002;26(1):76–81. doi: 10.1097/00000478-200201000-00009. - DOI - PubMed
    1. Yilmaz U, Unsal I, Halilcolar H, Anar C, Yildirim Y, Sanli A, Kargi A. Nodular lymphoid hyperplasia of the lung: the role of positron emission tomography in diagnosis. Tuberk Toraks. 2009;57(4):417–421. - PubMed

Publication types