RESUMO
A 46-year-old man presented with nonproductive cough and lower limb swelling. Chest radiograph showed a left lower lobe lung mass and multiple subpleural nodules. Other investigations revealed that he had nephrotic syndrome. Core biopsies of the left lower lobe lung mass showed features of inflammatory pseudotumor with endarteritis obliterans and a lymphoplasmacytic infiltrate. Immunohistochemical stain for Treponema pallidum was positive. Resolution of the lung mass and nephrotic syndrome was achieved after treatment with intramuscular benzathine benzylpenicillin. The differential diagnosis of pulmonary inflammatory pseudotumor, manifestations of pulmonary syphilis, and a literature review of secondary syphilis of the lung are discussed.
Assuntos
Pulmão/microbiologia , Granuloma de Células Plasmáticas Pulmonar/diagnóstico , Sífilis/diagnóstico , Treponema pallidum/isolamento & purificação , Biópsia , Humanos , Imuno-Histoquímica , Injeções Intramusculares , Pulmão/diagnóstico por imagem , Pulmão/patologia , Neoplasias Pulmonares/diagnóstico , Masculino , Pessoa de Meia-Idade , Penicilina G Benzatina/administração & dosagem , Granuloma de Células Plasmáticas Pulmonar/sangue , Granuloma de Células Plasmáticas Pulmonar/tratamento farmacológico , Granuloma de Células Plasmáticas Pulmonar/microbiologia , Sarcoma/diagnóstico , Sífilis/complicações , Sífilis/tratamento farmacológico , Sífilis/microbiologia , Sorodiagnóstico da SífilisRESUMO
We report a case of liver transplant patient who presented with lung masses, found to be Mycobacterium spindle cell pseudotumors. The masses demonstrated hypermetabolic activities on positron emission tomography. Core biopsy revealed sheets of spindle histiocytic cells with abundant acid-fast bacilli identified as Mycobacterium avium-intracellulare complex. This finding is a rare presentation of Mycobacterium infection, mainly nontuberculous Mycobaterium. It is characterized by a benign, spindle cell mass-forming reaction. Most of the reported cases had acquired immune deficiency syndrome or organ transplant. Histopathology illustrating the proliferation of spindle cell shaped histiocytes containing numerous acid-fast bacilli is the gold standard for diagnosis. The standard treatment has not been well established; previously reported cases followed the standard treatment for Mycobacterium based on organ involvement. Our case is the first case to our knowledge that reports pulmonary Mycobacterium spindle cell pseudotumors in a liver transplant recipient.
Assuntos
Transplante de Fígado , Complexo Mycobacterium avium/isolamento & purificação , Infecção por Mycobacterium avium-intracellulare/patologia , Granuloma de Células Plasmáticas Pulmonar/microbiologia , Idoso , Antibacterianos/administração & dosagem , Antibacterianos/uso terapêutico , Antituberculosos/administração & dosagem , Antituberculosos/uso terapêutico , Azitromicina/administração & dosagem , Azitromicina/uso terapêutico , Etambutol/administração & dosagem , Etambutol/uso terapêutico , Feminino , Humanos , Infecção por Mycobacterium avium-intracellulare/tratamento farmacológico , Infecção por Mycobacterium avium-intracellulare/microbiologia , Granuloma de Células Plasmáticas Pulmonar/diagnóstico , Granuloma de Células Plasmáticas Pulmonar/tratamento farmacológicoRESUMO
No disponible
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Granuloma de Células Plasmáticas Pulmonar/diagnóstico por imagem , Granuloma de Células Plasmáticas Pulmonar/tratamento farmacológico , Fibrose Pulmonar/diagnóstico , Fumantes , Hipotireoidismo/complicações , Biópsia por Agulha/métodos , Granuloma de Células Plasmáticas Pulmonar/complicações , Biomarcadores Tumorais , Carcinoma de Células Escamosas/patologia , Corticosteroides/uso terapêuticoRESUMO
La sarcoidosis es una enfermedad granulomatosa sistémica de causa desconocida, caracterizada por la presencia de granulomas no caseificantes en los órganos afectados. Afecta típicamente al pulmón de adultos de mediana edad. Se basa en un diagnóstico de exclusión, ya que no existe una prueba diagnóstica definitiva. Como tratamiento de primera línea se recomiendan los corticoesteroides, teniendo como alternativas los inmunosupresores, fundamentalmente el metotrexato, y las terapias biológicas. Presentamos el caso de un paciente de 43 años sin antecedentes de interés, enviado a consultas de neumología por pérdida de peso e imágenes de agrandamiento hiliar bilateral y ensanchamiento mediastínico derecho en la radiografía de tórax
Sarcoidosis is a multisystem granulomatous disorder of unknown etiology, characterized pathologically by the presence of noncaseating granulomas in involved organs (most frecuently the lung of middle aged adults). The most important part of the diagnosis is the exclusion of alternative possibilities, because a definitive diagnostic test for sarcoidosis does not exist. The essence of the treatment are corticosteroids. We present a 43- years-old male patient with no medical history of interest, who was sent to the pneumology outpatient department because of weight loss and bilateral hilar adenopathies and right paratracheal node enlargement on the radiography
Assuntos
Humanos , Masculino , Adulto , Sarcoidose Pulmonar/diagnóstico por imagem , Sarcoidose Pulmonar/tratamento farmacológico , Eritema Nodoso/complicações , Eritema Nodoso/diagnóstico , Corticosteroides/uso terapêutico , Mediastinite/diagnóstico por imagem , Qualidade de Vida , Granuloma de Células Plasmáticas Pulmonar/diagnóstico por imagem , Granuloma de Células Plasmáticas Pulmonar/tratamento farmacológico , Radiografia Torácica , Gasometria , Alcalose , PatologiaRESUMO
A 58-year-old man was admitted because of respiratory failure, episodic fever with chilling, cough, malaise, fatigue, myalgia and weight loss lasting for at least one month. Chest x-rays and CT scan of the chest showed bilateral pulmonary consolidations in upper lobes, the left lower lobe, and mediastinal lymphadenopathy. Bronchoscopy with cytology was unremarkable. A needle CT-guided lung biopsy documented an inflammatory pseudotumor, lymphoplasmacytic type. Serology showed high titer antibodies to phase II Coxiella burnetii infection. Therapy with doxycycline and hydroxychloroquine for three months led to a complete resolution of symptoms and radiological findings, and a marked decrease in titers to Q fever.
Assuntos
Coxiella burnetii/patogenicidade , Granuloma de Células Plasmáticas Pulmonar , Antibacterianos/uso terapêutico , Anticorpos Antibacterianos/sangue , Anticorpos Antibacterianos/imunologia , Coxiella burnetii/imunologia , Doxiciclina/uso terapêutico , Humanos , Hidroxicloroquina/uso terapêutico , Masculino , Pessoa de Meia-Idade , Granuloma de Células Plasmáticas Pulmonar/diagnóstico por imagem , Granuloma de Células Plasmáticas Pulmonar/tratamento farmacológico , Granuloma de Células Plasmáticas Pulmonar/microbiologia , Febre Q/tratamento farmacológico , Febre Q/microbiologia , RadiografiaRESUMO
Pulmonary nodule formation is a frequent feature of granulomatosis with polyangiitis (GPA). Traditional induction therapy includes methotrexate or cyclophosphamide, however, pulmonary nodules generally respond slower than vasculitic components of disease. Efficacy of rituximab (RTX) solely for the treatment of pulmonary nodules has not been assessed. In this observational cohort study, we report patient outcomes with RTX in GPA patients with pulmonary nodules who failed to achieve remission following conventional immunosuppression. Patients (n = 5) with persistent pulmonary nodules were identified from our clinic database and retrospectively evaluated. Systemic manifestations, inflammatory markers, disease activity, concurrent immunosuppression, and absolute B cell numbers were recorded pre-RTX and at 6 monthly intervals following treatment. Chest radiographs at each time point were scored by an experienced radiologist, blinded to clinical details. Five patients with GPA and PR3-ANCA were evaluated (2 male, 3 female), mean age 34 (22-52) years. Pulmonary nodules (median 4, range 2-6), with or without cavitation were present in all patients. RTX induced initial B cell depletion (<5 cells/µL) in all patients but re-population was observed in 3 patients. Repeated RTX treatment in these 3 and persistent B cell depletion in the whole cohort was associated with further significant radiological improvement. Radiographic scoring at each time interval showed reduction in both number of nodules (P = â<0.0001) and largest nodule diameter (P =â <0.0001) in all patients for at least 18 months following B cell depletion. In summary, RTX therapy induces resolution of pulmonary granulomatous inflammation in GPA following prolonged B cell depletion.
Assuntos
Anticorpos Monoclonais Murinos/uso terapêutico , Linfócitos B/efeitos dos fármacos , Granulomatose com Poliangiite/tratamento farmacológico , Fatores Imunológicos/uso terapêutico , Granuloma de Células Plasmáticas Pulmonar/tratamento farmacológico , Adulto , Anticorpos Monoclonais Murinos/farmacologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Granuloma de Células Plasmáticas Pulmonar/diagnóstico por imagem , Radiografia , Estudos Retrospectivos , Rituximab , Resultado do Tratamento , Adulto JovemAssuntos
Criptococose/diagnóstico , Imunocompetência/imunologia , Pneumopatias Fúngicas/diagnóstico , Granuloma de Células Plasmáticas Pulmonar/diagnóstico , Adulto , Antifúngicos/uso terapêutico , Biópsia , Biópsia por Agulha , Broncoscopia , Terapia Combinada , Criptococose/tratamento farmacológico , Criptococose/imunologia , Criptococose/patologia , Fluconazol/uso terapêutico , Humanos , Assistência de Longa Duração , Pulmão/patologia , Pneumopatias Fúngicas/tratamento farmacológico , Pneumopatias Fúngicas/imunologia , Pneumopatias Fúngicas/patologia , Masculino , Granuloma de Células Plasmáticas Pulmonar/tratamento farmacológico , Granuloma de Células Plasmáticas Pulmonar/imunologia , Granuloma de Células Plasmáticas Pulmonar/patologia , Pneumonectomia , Radiografia Intervencionista , Toracotomia , Tomografia Computadorizada por Raios XRESUMO
Hyper IgG4 disease is a recently described inflammatory disease characterized by lymphoplasmacytic infiltration leading to fibrosis and tissue destruction. Whereas most cases have been successfully treated with corticosteroids, recurrent or refractory cases may benefit from alternative therapies. Bortezomib has proven to be successful in the treatment of multiple myeloma, and its mechanism indicates that it may have merit in autoimmune or other plasmacytic disorders. We report a patient with recurrent pulmonary infiltration with IgG4 plasma cells, consistent with hyper IgG4 disease, who was successfully treated using a bortezomib-based combination with minimal therapy-related toxicities.
Assuntos
Antineoplásicos/uso terapêutico , Ácidos Borônicos/uso terapêutico , Doenças do Sistema Imunitário/tratamento farmacológico , Doenças do Sistema Imunitário/patologia , Imunoglobulina G , Pirazinas/uso terapêutico , Anti-Inflamatórios/uso terapêutico , Bortezomib , Ciclofosfamida/uso terapêutico , Dexametasona/uso terapêutico , Doenças Palpebrais/tratamento farmacológico , Doenças Palpebrais/etiologia , Doenças Palpebrais/patologia , Feminino , Humanos , Pessoa de Meia-Idade , Granuloma de Células Plasmáticas Pulmonar/tratamento farmacológico , Granuloma de Células Plasmáticas Pulmonar/etiologia , Granuloma de Células Plasmáticas Pulmonar/patologia , Prednisona/uso terapêutico , Tomografia Computadorizada por Raios XAssuntos
Miofibroma/diagnóstico , Granuloma de Células Plasmáticas Pulmonar/diagnóstico , Corticosteroides/uso terapêutico , Adulto , Sequestro Broncopulmonar/diagnóstico , Calcinose/diagnóstico por imagem , Calcinose/etiologia , Tumor Carcinoide/diagnóstico , Carcinoma/diagnóstico , Terapia Combinada , Diagnóstico Diferencial , Humanos , Inflamação , Neoplasias Pulmonares/diagnóstico , Masculino , Pessoa de Meia-Idade , Miofibroma/tratamento farmacológico , Miofibroma/secundário , Miofibroma/cirurgia , Granuloma de Células Plasmáticas Pulmonar/tratamento farmacológico , Granuloma de Células Plasmáticas Pulmonar/cirurgia , Pneumonectomia , Pneumonia/etiologia , Recidiva , Tomografia Computadorizada por Raios XRESUMO
In a recent outbreak in British Columbia (BC), Canada, Cryptococcus gattii, a rare species of Cryptococcus, was noted to affect primarily immunocompetent hosts and cause limited pulmonary or CNS disease. We herein report a rare case of a pulmonary inflammatory myofibroblastic tumor caused by a Cryptococcus infection, presumed to be of the gattii species, in a 20-year-old immunocompetent college student from Vancouver, BC who presented with a large lung mass. The diagnosis was first made on the fine needle aspirate (FNA) material and was confirmed on the concurrent histologic core biopsy. Cryptococcal inflammatory myofibroblastic tumors have been reported, but neither in the lung nor in the setting of an immunocompetent host. Pulmonary cryptococcosis should therefore be considered in the differential diagnosis of a lung mass, even in an immunocompetent host, especially if the clinical history reveals recent travel to British Columbia where Cryptococcus gattii is endemic.
Assuntos
Criptococose/patologia , Granuloma de Células Plasmáticas Pulmonar/patologia , Antifúngicos/uso terapêutico , Biópsia por Agulha Fina , Criptococose/tratamento farmacológico , Cryptococcus gattii , Feminino , Fluconazol/uso terapêutico , Humanos , Granuloma de Células Plasmáticas Pulmonar/tratamento farmacológico , Adulto JovemRESUMO
The case of a 37-year-old woman with an inflammatory pseudotumour of the lung is reported. Inflammatory pseudotumour of the lung is a rare disease predominantly occurring in younger patients. Because of its rarity as well as its usually unspecific clinical and radiological presentation, this disease constantly causes diagnostic and therapeutic difficulties. The case report is followed by a short overview of the literature.
Assuntos
Emigrantes e Imigrantes , Granuloma de Células Plasmáticas Pulmonar/diagnóstico , Adulto , Antituberculosos/uso terapêutico , Ásia/etnologia , Biópsia , Diagnóstico Diferencial , Quimioterapia Combinada , Feminino , Alemanha , Humanos , Pulmão/patologia , Neoplasias Pulmonares/diagnóstico , Infecções por Mycobacterium não Tuberculosas/diagnóstico , Infecções por Mycobacterium não Tuberculosas/tratamento farmacológico , Infecções por Mycobacterium não Tuberculosas/patologia , Granuloma de Células Plasmáticas Pulmonar/tratamento farmacológico , Granuloma de Células Plasmáticas Pulmonar/patologia , Tomografia Computadorizada por Raios XRESUMO
The standard treatment of inflammatory pseudotumor of the lung is surgical excision. However, little data is available on steroid therapy in patients with the unresectable disease. Here, we report a patient with recurrent inflammatory pseudotumor of the lung with pleural involvement who had been successfully treated with corticosteroid eleven years previously. Like the previous treatment, retreatment with corticosteroid proved to be effective for the recurred lesion. In addition, the patient had developed extramammary Paget's disease and bladder cancer after the initial onset of inflammatory pseudotumor. Steroid therapy could be an optional modality in treating unresectable inflammatory pseudotumor, although long-term follow-up is definitely necessary.
Assuntos
Corticosteroides/uso terapêutico , Granuloma de Células Plasmáticas Pulmonar/diagnóstico , Granuloma de Células Plasmáticas Pulmonar/tratamento farmacológico , Idoso , Humanos , Masculino , Recidiva , Indução de Remissão , Resultado do TratamentoRESUMO
Inflammatory pseudotumor is a non-neoplastic process characterized by irregular growth of inflammatory cells. This type of tumor can arise in any part of the body; most are confined to a single site and are benign. We present the case of a 51-year-old man in whom a solitary pulmonary nodule was detected as an incidental finding. Right pulmonary lobectomy was performed and histopathological analysis led to a diagnosis of inflammatory pseudotumor. The patient subsequently developed tumors in the contralateral lung and cervix, the latter being highly aggressive. We found no reports of this association in the literature, prompting the present case report.
Assuntos
Granuloma de Células Plasmáticas Pulmonar/patologia , Anti-Inflamatórios/uso terapêutico , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Granuloma de Células Plasmáticas Pulmonar/tratamento farmacológico , Granuloma de Células Plasmáticas Pulmonar/cirurgia , Nódulo Pulmonar Solitário/patologia , Nódulo Pulmonar Solitário/cirurgia , Procedimentos Cirúrgicos OperatóriosRESUMO
Lung involvement is rare in Waldenström macroglobulinemia (WM). We encountered a male patient with WM who complained of breathlessness. Chest X-ray revealed diffuse infiltrative shadow throughout the both lungs. Transbronchial biopsy showed infiltration of atypical plasmacytoid lymphocytes and non-caseating granuloma. We treated the patients with fludarabine phosphate, and both his symptom and X-ray findings were then improved. To our knowledge, this is the first case showing non-caseating granuloma with lung involvement of WM. We discuss a mechanism of non-caseating granuloma formation in this case.
Assuntos
Granuloma de Células Plasmáticas Pulmonar/etiologia , Macroglobulinemia de Waldenstrom/complicações , Antimetabólitos Antineoplásicos/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Granuloma de Células Plasmáticas Pulmonar/diagnóstico por imagem , Granuloma de Células Plasmáticas Pulmonar/tratamento farmacológico , Radiografia , Resultado do Tratamento , Fosfato de Vidarabina/análogos & derivados , Fosfato de Vidarabina/uso terapêutico , Macroglobulinemia de Waldenstrom/diagnóstico por imagem , Macroglobulinemia de Waldenstrom/tratamento farmacológicoRESUMO
Inflammatory pseudotumor (plasma cell granuloma) of the lung is an uncommon nonneoplastic tumor of unknown origin. This tumor typically manifests as a solitary, peripheral, and sharply circumscribed mass. Multiple lesions are seen in about 5% of cases. Resection is recommended for both diagnosis and treatment, and this tumor does not generally recur after complete resection. Here, we report a case of recurrent inflammatory pseudotumor after complete resection; the recurrence was detected as a series of bilateral consolidated lesions with an internal air bronchogram. This is an unusual finding with regard to inflammatory pseudotumors.
Assuntos
Granuloma de Células Plasmáticas Pulmonar/diagnóstico , Pneumonectomia , Biópsia por Agulha , Seguimentos , Glucocorticoides/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Granuloma de Células Plasmáticas Pulmonar/tratamento farmacológico , Granuloma de Células Plasmáticas Pulmonar/cirurgia , Prednisolona/uso terapêutico , Radiografia Torácica , Recidiva , Estudos Retrospectivos , Tomografia Computadorizada por Raios XRESUMO
Inflammatory myofibroblastic tumor (IMT) is an uncommon cause of solitary or multifocal lung nodules and can also be rarely found in various other extrapulmonary sites. Although this pseudotumor is benign, it can be locally very aggressive. The pathogenesis of IMT remains unclear; autoimmune or infectious origins have been hypothesized, so far. Here, we report a case of inflammatory pseudotumor of the lung secondary to invasive pulmonary aspergillosis in a patient with chronic graft-vs.-host disease. The 42-year-old patient presented with coughing and hemoptysis as major clinical signs 1 yr after successful HLA-identical stem cell transplantation. Aspergillus fumigatus was cultured from the bronchoscopic lavage, but intensive antifungal treatment could only initially improve the clinical situation. Diagnostic re-evaluation by open-chest biopsy surprisingly revealed an inflammatory pseudotumor responsible for clinical and radiographical deterioration. Both clinical and radiographical signs resolved under long-term steroids and secondary antifungal prophylaxis.
Assuntos
Aspergilose/patologia , Doença Enxerto-Hospedeiro , Pneumopatias Fúngicas/patologia , Granuloma de Células Plasmáticas Pulmonar/patologia , Transplante de Células-Tronco , Adulto , Antifúngicos/uso terapêutico , Aspergilose/diagnóstico por imagem , Aspergilose/prevenção & controle , Doença Enxerto-Hospedeiro/complicações , Humanos , Pneumopatias Fúngicas/diagnóstico por imagem , Pneumopatias Fúngicas/prevenção & controle , Masculino , Granuloma de Células Plasmáticas Pulmonar/tratamento farmacológico , Granuloma de Células Plasmáticas Pulmonar/microbiologia , Esteroides/uso terapêutico , Tomografia Computadorizada por Raios XRESUMO
The term pulmonary pseudotumor may be used to describe a well-demarcated interlobar pleural effusion. Pseudotumors are located within pulmonary fissures and are commonly associated with congestive heart failure and other processes that cause transudative pleural effusions. Pseudotumors are typically diagnosed presumptively on chest radiographs based on their lenticular configuration. We report a case of a massive pseudotumor opacifying one third of the right hemithorax on a frontal radiograph. CT scan of the chest showed a loculated effusion within the oblique fissure measuring 10 x 5 cm. The Hounsfield unit characteristic of the effusion was similar to that of freely layering liquid in the contralateral hemithorax that was shown to be a transudate. The pseudotumor resolved with medical management over 8 weeks. This case proves that even a massive pulmonary pseudotumor will resolve with conservative management.
Assuntos
Granuloma de Células Plasmáticas Pulmonar/diagnóstico por imagem , Idoso , Antibacterianos/uso terapêutico , Diagnóstico Diferencial , Diuréticos/uso terapêutico , Humanos , Masculino , Granuloma de Células Plasmáticas Pulmonar/tratamento farmacológico , Derrame Pleural/sangue , Derrame Pleural/diagnóstico , Radiografia , Vancomicina/uso terapêuticoRESUMO
A 39-year-old man had bilateral proptosis and blurred vision for I week. Computed tomography and magnetic resonance imaging showed signs of bilateral orbital pseudotumor, a suprasellar mass, and pulmonary infiltration. Biopsies from retrobulbar and bronchial sites showed similar inflammatory tissue. His disease resolved with pulsed corticosteroid therapy.
Assuntos
Encefalopatias/complicações , Pseudotumor Orbitário/complicações , Granuloma de Células Plasmáticas Pulmonar/complicações , Adulto , Azatioprina/uso terapêutico , Encefalopatias/diagnóstico , Encefalopatias/tratamento farmacológico , Quimioterapia Combinada , Exoftalmia/diagnóstico , Exoftalmia/etiologia , Glucocorticoides/uso terapêutico , Granuloma de Células Plasmáticas/complicações , Granuloma de Células Plasmáticas/diagnóstico , Granuloma de Células Plasmáticas/tratamento farmacológico , Humanos , Imageamento por Ressonância Magnética , Masculino , Metilprednisolona/uso terapêutico , Pseudotumor Orbitário/diagnóstico , Pseudotumor Orbitário/tratamento farmacológico , Granuloma de Células Plasmáticas Pulmonar/diagnóstico , Granuloma de Células Plasmáticas Pulmonar/tratamento farmacológico , Prednisolona/uso terapêutico , Tomografia Computadorizada por Raios X , Transtornos da Visão/diagnóstico , Transtornos da Visão/etiologia , Acuidade VisualRESUMO
A-25 sephadex-induced granulomatous inflammation of the lungs in rats was treated with beta-carotene and intal in inhalations. Both drugs showed antiinflammatory activity reducing the area of alveolitis and emphysema in the lungs, number of neutrophils and lymphocytes in the bronchoalveolar fluid. The experimental data allow to recommend further trial of intal and beta-carotene in granulomatous pulmonary diseases.
Assuntos
Anti-Inflamatórios/uso terapêutico , Cromolina Sódica/uso terapêutico , Modelos Animais de Doenças , Granuloma de Células Plasmáticas Pulmonar/tratamento farmacológico , beta Caroteno/uso terapêutico , Animais , Líquido da Lavagem Broncoalveolar/citologia , Dextranos , Avaliação Pré-Clínica de Medicamentos , Pulmão/efeitos dos fármacos , Pulmão/patologia , Granuloma de Células Plasmáticas Pulmonar/induzido quimicamente , Granuloma de Células Plasmáticas Pulmonar/patologia , Ratos , Ratos Wistar , Fatores de TempoRESUMO
A 75-year-old woman was admitted to our hospital with persistent fever, productive cough and systemic symptoms of two months' duration. A chest film showed bilateral infiltration in the form of subpleural plaques with multiple satellite nodules in both lung fields. The biopsy specimens taken by thoracoscopy were compatible with inflammatory pulmonary pseudotumor. Lung resection was ruled out because the lesions were bilateral and corticosteroid treatment was instated. The clinical and radiologic response was excellent and the patient was asymptomatic after 30 months of low-dose corticoid therapy.