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Walid Hadid, MD; Dana Rifai, MD; Odile David, MD; Ruxana T. Sadikot, MD, FCCP
Author and Funding Information

From the Division of Pulmonary, Critical Care and Sleep Medicine (Drs Hadid and Rifai), and Pathology Department (Dr David), University of Illinois at Chicago; and the Division of Pulmonary, Critical Care and Sleep Medicine (Dr Sadikot), University of Florida.

Correspondence to: Walid Hadid, MD, Department of Medicine, University of Illinois at Chicago, 840 S Wood St, MC 719, Chicago, IL 60612-7323; e-mail: whadid70@yahoo.com


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):1176-1177. doi:10.1378/chest.14-0340
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To the Editor:

We thank Dr Srivali and colleagues for their letter regarding our case report.1 We appreciate their added contribution of two other CT scan findings that are more commonly seen in other disease processes and reiterate the important point that diagnosis of lymphomatoid granulomatosis (LYG) often is a challenge and confirm that there are no specific radiologic findings of LYG. We would like to note that despite the nomenclature, granulomas are not a histologic feature of this entity. The hallmark of LYG is a mixed mononuclear cell infiltrate containing large, variably atypical B cells and small T cells, often along with plasma cells and histiocytes, which replaces the lung parenchyma and shows vascular infiltration. Necrosis and positivity for Epstein-Barr virus encoded RNA by in situ hybridization are frequent and supportive findings.2

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]
 
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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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]
 
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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