title: Pyrexia, Lung nodules, Granulomas: Pulmonary Lymphomatoid Granulomatosis.
abstract: The differential diagnosis of pyrexia, lung nodules and granulomas includes tuberculosis, vasculitis and rarely a malignancy. In countries where tuberculosis or histoplasmosis is endemic, these are the first consideration and often ruled out by microbiological investigations. Vasculitis like granulomatosis with polyangitis (Wegener's granulomatosis), Churg strauss syndrome and sarcoidosis, which are the second consideration, are ruled out by serological investigations. Confirmation of malignancy merits histopathology. This case highlights how a rare diagnosis of pulmonary lymphomatoid granulomatosis was reached after an open lung biopsy. The following case also describes the natural history of this rare disease as it showed transient spontaneous remission but ultimately required therapy.
authors.affiliation: Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012 India.
authors.forename: Deepesh
authors.initials: D
authors.lastname: Lad
authors.affiliation: Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012 India.
authors.forename: Pankaj
authors.initials: P
authors.lastname: Malhotra
authors.affiliation: Department of Pulmonary Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012 India.
authors.forename: Dipesh
authors.initials: D
authors.lastname: Maskey
authors.affiliation: Department of Nuclear Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012 India.
authors.forename: Sampath
authors.initials: S
authors.lastname: Santhosh
authors.affiliation: Department of Nuclear Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012 India.
authors.forename: B R
authors.initials: BR
authors.lastname: Mittal
authors.affiliation: Department of Pathology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012 India.
authors.forename: Ashim
authors.initials: A
authors.lastname: Das
authors.affiliation: Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012 India.
authors.forename: Subhash
authors.initials: S
authors.lastname: Varma
keywords: Granulomas; Lung nodules; Pulmonary lymphomatoid granulomatosis; Pyrexia