AB 32. Pulmonary nodular lympoid hyperplasia. Case
Background: Nodular lymphoid hyperplasia is considered to represent
a localized form of lymphoid hyperplasia, which presents as a discreet
pulmonary mass or masses Median age of diagnosis are 65 years (range,
19-80 years). Chest X-ray and CT scan show an isolated mass (64%)
or multiple nodules (36%). Hilar or mediastinal adenopathy may be
present is some patients.
Patients and methods: We describe the case of nodular lymphoid
hyperplasia in a 52 year-old woman who presented with pulmonary
multiple nodules, bilateral and mediastinal adenopathy, apparent by
chest X-ray and CT-scan. Open biopsy was performed from the upper
and down lobe of the right lung and from the mediastinal lymph nodes.
Macroscopic examination revealed small white nodules, measuring 0.3
to 0.7 cm in maximum diameter. The sections were examined with H+E
and followed by immunohistochemical study.
Results: Histological examination revealed multiple well demarcated
nodules consisting of aggregates of lymphoid follicles and sheets of
interfollicular small lymphocytes and plasma cells. Lymphoepithelial
lesions were absent. The immunohistochemical stains for lymphoid
markers were consistent with a reactive process. Bcl-2 protein expression
was absent in geminal centers, but presented in the mantle zone and
interfollicular T-cells. Similar were the immunohistochemical findings
of the lymph nodes study.
Conclusions: Nodular lymphoid hyperplasia is a benign lesion,
although surgical excision is usually needed to allow correct diagnosis.
The main entity in the differential diagnosis of nodular lymphoid
hyperplasia is BALT lymphoma.
Cite this abstract as: Papaemmanouil S, Iordanidis F, Moraitis D, Sakkas
L. Pulmonary nodular lympoid hyperplasia. Case report. J Thorac Dis
2012;4(S1):AB32. DOI: 10.3978/j.issn.2072-1439.2012.s032