pair cases of pulmonary plasma solitary abode; squalid granuloma that progressed after respiratory infectious disease are described.

pair cases of pulmonary plasma solitary abode; squalid granuloma that progressed after respiratory infectious disease are described. The men 48 and 32 years antiquated were admitted to the hospital with blood-streaked sputum and mass or nodular shadow forward chest radiograph. Close examination revealed that these tumors were plasma small room granulomas, which are known as postinflammatory pseudotumors. Biopsy specimens, obtained by means of way of transbronchial biopsy, demonstrated proliferation of mature plasma solitary abode; squalids and infiltration of lymphocytes supported according to granulation tissue, and there was no evidence of malignancy or tuberculosis. Although surgery is universal in the treatment of pulmonary plasma enclosed space granuloma, some cases relapse or invade the mediastinum. Therefore, we decided to treat these patients with prednisolone, 30 mg/d an anti-inflammatory and immunosuppressive agent. sum of two units or 4 weeks later, these tumors disappeared completely and they have at no time recurred. As middle-dosage corticosteroid therapy is not cytotoxic, it is useful for the treatment of pulmonary plasma lonely dwelling granuloma, especially in multifocal, unresectable, and/or relapsing cases.

Plasma confined apartment granuloma, a rare disease occurring as a pulmonary nodular lesion, was first reported in detail by the agency of Bahadori and Liebow.[1] This disease come to passs in all ages and many times involves the lung and gastrointestinal tract.[2] Histopathologically, it is characterized through proliferation of mature plasma small cavitys and endothelial cells supported on a stroma of granulation tissue and by dint of infiltration of lymphocytes and large mononuclear cells[3]

Although the lesion is histologically benign, a certain number of cases include subsequent malignancy or tuberculous lesions, widen into the mediastinum, or involve the mediastinal lymph nodes. Almost all of the patients experience surgical treatment to differentiate the condition from malignancy, if it were not that rare cases have been reported in which patients be agreeable to to corticosteroid therapy.[4,5] We at hand two patients with pulmonary plasma small room glanuloma that occurred after airway inflammatory disease; they had advantageous response to middle-dosage corticosteroid therapy.

CASE REPORTS

CASE 1

A 48-year-old man was admitted to the hospital in March 1992 with blood-streaked sputum and an abnormal shadow forward chest radiograph. He was well until January 1992 nevertheless the first week in February, he caught a universal cold; nonproductive cough, sore throat, and night sweating unfolded There were no other symptoms similar as high fever or material substance weight loss, and there was no change in activity. His medical or family history was not remarkable. flows of the physical exmination were entirely unremarkable. The chest radiograph and chest comput tomographic (CT) scan at the time of hospital admission (Fig 1) revealed a mass lesion in the left lower lung field with clear margin. No mediastinal lymph nodes were swollen Serologic criterions revealed mild inflammatory change and erythrocyte sedimentation rate was accelerated. Serum tumor markers were not elevated. Bronchoscopically, blooming bronchial bleeding was not observ and biopsy specimens obtained from the mass lesion not absented the concentration of mature plasma small cavitys and lymphocytes supported by granulation tissue. by means of way of immunohistochemical examination, these plasma small rooms were enclosed to present polyclonal proliferation: IgG ([+ or -]) IgA (+) IgA (+) The patient was administered prednisolone, 30 mg/d and 2 weeks later, the mass lesion of plasma small cavity granuloma disappeared except for marginal fibrotic change in succession chest radiograph and chest CT scan (Fig 2) Serologic inflammatory reaction changed to negative. Also, transbronchial biopsy specimen revealed single a nonspecific inflammatory change. During and after the steroid therapy, return was not detected.

CASE 2

A 32-year-old man was admitted to the hospital in May 1992 with productive cough and high ferment with shaking chills. He had standed from gastric ulcer and administered [H.sub.2]-antagonist (Famotidine, 40 mg/d) each day. Because serologic touchstones revealed marked inflammatory change and chest radiograph showed an infiltration in the right middle and lower lung fields with air bronchogram, we diagnosed his condition as pneumonia and treated it with piperacillin, 4 g/d Seven days later, serologic proof results changed to negative and the infiltration disappeared; however, a nodular lesion with clear margin and central cavitation appeared in the right lower lung field forward chest radiograph and chest CT scan without any mediastinal lymphadenopathy. Because bronchoscopy and immunohistochemical examination revealed that this case was polyclonal plasma small cavity granuloma with no malignancy or tuberculosis, we started middle-dosage corticosteroid therapy (prednisolone, 30 mg/d) each day. Two weeks later, the central cavity enlarged and tumor size reduced; after 2 more weeks, the cavitary nodule completely disappeared. return was not detected after steroid therapy.

DISCUSSION

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