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Correspondence |

Another Rare Finding of Lymphomatoid Granulomatosis on CT ScanCT Scan Finding of Lymphomatoid Granulomatosis FREE TO VIEW

Narat Srivali, MD; Khemtana Jariyawat, MD; Patompong Ungprasert, MD
Author and Funding Information

From the Department of Medicine (Drs Srivali and Ungprasert), Bassett Medical Center; and Department of Medicine (Dr Jariyawat), Ramathibodi Hospital.

Correspondence to: Narat Srivali, MD, Bassett Medical Center, Medicine, One Atwell Rd, Cooperstown, NY 13326; e-mail: narat.srivali@bassett.org


Financial/nonfinancial disclosures: The authors have reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2014;145(5):1176. doi:10.1378/chest.14-0129
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To the Editors:

We thank Hadid et al1 for their article in CHEST (January 2014). The authors wrote an excellent case report concerning a lung mass subsequently diagnosed as lymphomatoid granulomatosis (LYG). The authors reported that common findings on CT scan are peribronchovascular distribution of nodules, coarse irregular opacities, small thin-wall cysts, small nodules, and, rarely, a mass, as presented in this case.

We would like to share two other findings on CT scan in LYG, including reversed halo sign2 and air crescent sign.3 The reversed halo sign is a focal round area of ground-glass attenuation and surrounding airspace consolidation of crescent shape that is more commonly seen in cryptogenic organizing pneumonia.4 The air crescent sign is crescentic and radiolucent due to a lung cavity that is filled with air and has a round radiopaque mass that is most commonly found in pulmonary aspergillosis.5 Diagnosis of LYG is often a challenge, as it mimics many other more common pulmonary conditions,6 and, therefore, the histologic triad of polymorphic lymphocytic infiltrate, angiitis, and granulomatosis with central necrosis is required for definitive diagnosis.7

References

Hadid W, Rifai D, David O, Sadikot RT. A woman in her 40s with AIDS and lung mass. Chest. 2014;145(1):173-177. [CrossRef] [PubMed]
 
Lota HK, Dusmet M, Steele K, et al. A rapidly growing lung mass with air crescent formation. Thorax. 2013;68(4):394-395. [CrossRef] [PubMed]
 
Benamore RE, Weisbrod GL, Hwang DM, et al. Reversed halo sign in lymphomatoid granulomatosis. Br J Radiol. 2007;80(956):e162-e166. [CrossRef] [PubMed]
 
Kim SJ, Lee KS, Ryu YH, et al. Reversed halo sign on high-resolution CT of cryptogenic organizing pneumonia: diagnostic implications. AJR Am J Roentgenol. 2003;180(5):1251-1254. [CrossRef] [PubMed]
 
Abramson S. The air crescent sign. Radiology. 2001;218(1):230-232. [CrossRef] [PubMed]
 
Bartosik W, Raza A, Kalimuthu S, Fabre A. Pulmonary lymphomatoid granulomatosis mimicking lung cancer. Interact Cardiovasc Thorac Surg. 2012;14(5):662-664. [CrossRef] [PubMed]
 
Katzenstein AL, Doxtader E, Narendra S. Lymphomatoid granulomatosis: insights gained over 4 decades. Am J Surg Pathol. 2010;34(12):e35-e48. [CrossRef] [PubMed]
 

Figures

Tables

References

Hadid W, Rifai D, David O, Sadikot RT. A woman in her 40s with AIDS and lung mass. Chest. 2014;145(1):173-177. [CrossRef] [PubMed]
 
Lota HK, Dusmet M, Steele K, et al. A rapidly growing lung mass with air crescent formation. Thorax. 2013;68(4):394-395. [CrossRef] [PubMed]
 
Benamore RE, Weisbrod GL, Hwang DM, et al. Reversed halo sign in lymphomatoid granulomatosis. Br J Radiol. 2007;80(956):e162-e166. [CrossRef] [PubMed]
 
Kim SJ, Lee KS, Ryu YH, et al. Reversed halo sign on high-resolution CT of cryptogenic organizing pneumonia: diagnostic implications. AJR Am J Roentgenol. 2003;180(5):1251-1254. [CrossRef] [PubMed]
 
Abramson S. The air crescent sign. Radiology. 2001;218(1):230-232. [CrossRef] [PubMed]
 
Bartosik W, Raza A, Kalimuthu S, Fabre A. Pulmonary lymphomatoid granulomatosis mimicking lung cancer. Interact Cardiovasc Thorac Surg. 2012;14(5):662-664. [CrossRef] [PubMed]
 
Katzenstein AL, Doxtader E, Narendra S. Lymphomatoid granulomatosis: insights gained over 4 decades. Am J Surg Pathol. 2010;34(12):e35-e48. [CrossRef] [PubMed]
 
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