Pulmonary hyalinizing granuloma is a rare non-neoplastic fibrosclerosing inflammatory lung condition. Lesions are often identified incidentally on routine chest radiography. Pulmonary hyalinizing granuloma generally occurs in adults, with no sex predilection. Symptoms may include cough, shortness of breath, fatigue, fever, chest pain, and rarely, hemoptysis. About one-fourth of patients are asymptomatic. Grossly, pulmonary hyalinizing granulomas are generally well-circumscribed peripheral lung nodules measuring 2 to 3 cm in diameter, with a tan homogeneous cut surface. They may be solitary or multiple.

Pulmonary hyalinizing granuloma is sometimes associated with sclerosing mediastinitis and retroperitoneal fibrosis. Most cases are associated with Histoplasma infection. An association with Aspergillus has also been reported. In occasional cases of pulmonary hyalinizing granuloma, the presence of a pulmonary mass and sclerosing mediastinitis may clinically mimic a lung cancer with mediastinal extension or metastasis. Differential diagnosis includes tuberculosis, histoplasmosis, inflammatory pseudotumor, nodular amyloidosis, rheumatoid nodule, Hodgkin disease, Wegener granulomatosis, and solitary fibrous tumor.