Lymphoid Nodular Hyperplasia of the Lung: A Case Report

Case Report

Austin Surg Case Rep. 2020; 5(1): 1034.

Lymphoid Nodular Hyperplasia of the Lung: A Case Report

El Ochi MR1,3*, El Hammoumi M2,3, Kessab A1,3, Azakhmam M1,3, Essaoudi MA1,3, El Ktaibi A1,3, Kabiri EH2,3, Oukabli M1,3 and Albouzidi A1,3

¹Department of Anatomy and Pathological Cytology of Mohammed V Military Hospital, Rabat

²Department of Thoracic surgery of Mohammed V Military Hospital, Rabat

³Faculty of Medicine and Pharmacy, Mohammed V University, Rabat

*Corresponding author: El Ochi MR, Department of Anatomy and Pathological Cytology of Mohammed V Military Hospital, Rabat

Received: January 06, 2020; Accepted: February 04, 2020; Published: February 11, 2020


Nodular lymphoid hyperplasia is a controversial entity in which its existence in the lung has been questioned. The current view is that most, if not all, of these cases represent extra nodal marginal zone cell B lymphomas disguised as reactive lesions.

Our patient is 26 years old, with no specific history who consulted for a chronic dry cough with deterioration in general condition, resulting in weight loss estimated at 12 kg in 12 months.

The clinical examination shows a stable patient with no suggestive clinical signs which led to a chest scan revealing the presence of three pulmonary nodules which are hyper metabolic with mediastinal lymphadenopathy in the Pet Scan.

Histological and immunohistochemical studies have confirmed the diagnosis of lymph node nodular hyperplasia of the lung.

We conclude that nodular lymphoid hyperplasia of the lung, although rare, exists and deserves its place in the spectrum of reactive pulmonary lesions which ranges from follicular hyperplasia to diffuse hyperplasia of lymphoid tissue associated with the bronchi (lymphoid interstitial pneumonia).

Keywords: Hyperplasia; pseudo lymphoma; Pet Scan; lung


PNLH: Pulmonary Nodular Lymphoid Hyperplasia; MALT LYMPHOMA: Lymphoma of Lymphoid Tissue Associated With Mucosa; RSD: Related Sclerosing Disease


Pulmonary Nodular Lymphoid Hyperplasia (PNLH) is a reactive lymphoproliferative disease. It is very rare that this means that many aspects of the disease are unknown or have not been proven. Lung nodular lymphoid hyperplasia can be symptomatic or asymptomatic, progressive or not, solitary or multiple.

Pulmonary nodular lymphoid hyperplasia has a good prognosis, and surgical excision is curative [1]. Among the neoplastic processes which presents itself as a differential diagnosis, we note the lymphoma of the marginal zone associated with the mucous membranes (MALT lymphoma). However, the differential histological diagnosis also includes non-neoplastic diseases such as sclerosis linked to immunoglobulin G4 (IGG4-RSD) and certain types of interstitial pneumonia.

Unlike PNLH, the other diseases representing differential diagnoses require systemic treatment instead of surgical excision alone. Therefore, an accurate diagnosis is crucial. The diagnosis of PNLH can be established on the clinical-radiological, histological and immunohistochemical aspects.

Presentation Case

Our patient is a young 26 year old with no particular history who presented to the consultation for a chronic dry cough in a context of deterioration of the general state translated by a loss of weight calculated by 12 kg in 1 year without signs of tuberculous impregnation (night sweats, fever, chills, productive cough ...). Additional examinations were requested with the presence of pulmonary nodules on the standard radio (Figure 1) and the thoracic scanner (two on the right and one on the left) which are hyper metabolic at PETSCAN with mediastinal adenopathy (figure 2). Surgical resection of two nodules was made.