Lymphomatoid Granulomatosis

Rule In Rule Out

Clinical
 Patient age (56 years old): LG occurs in  Patient sex (female): LG occurs more
the 5-6th decade of life often in males than in females (2:1)
 Dyspnea Associated with EBV
 Dry Cough  No Fever: LG usually manifests with
 Unexplained weight loss fever
 History of an immune deficiency

Radiographic Findings
 CXR: Multiple dense ill-defined nodules
of variable size in both lungs
 Chest CT scan: Multiple pulmonary
nodules, bilateral
Histologic Findings
Cytology  Need for EBV+
 Presence of diffuse alveolar hemorrhage:
angiitis and vasculitis because of
lymphocytic transmural infiltration
Biopsy
 infiltration and destruction of epithelial
structures
 CD3+ and CD20+ immuno staining
 Presence of small lymphocytes,
histiocytes, plasma cells, and large
transformed lymphocytes
 Presence of granulomas
Case Slide Actual Slide
1) Fibrosis 1) Inconspicuous large atypical cells
2) Granuloma 2) Blood vessel
3) Epitheloid cells and fibroblast 3) Alveolar space
4) Central caseous necrosis 4) Alveolar epithelium (with
infiltrates)

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