Nodular lymphoid hyperplasia (NLH), referred to in the past as pseudolymphoma (a term to be avoided), is a rare reactive lymphoid proliferative disorder generally presenting in adults, some of whom have an altered immune status due to autoimmune disease, HIV infection, or collagen vascular disease. Chest x-ray may show reticulonodular changes. Lesions are usually identified incidentally and surgical excision may be both diagnostic and therapeutic. Nodules may be solitary or multifocal. NLH is part of a spectrum of lymphoid change that includes lymphocytic interstitial pneumonia. Paraesophageal, mediastinal, and hilar lymph nodes may exhibit associated follicular hyperplasia. Solitary lesions are generally treated with surgical excision, while patients with multifocal disease may benefit from cytotoxic drugs or steroids.