Intrathoracic Fibrocaseous Granuloma of Obscure Origin

A Ten Year Survey

¹ Thoracic Surgery Service, Fitzsimons General Hospital

1. Surgical biopsy of fibrocaseous granulomata of the lung or mediastinum has been accomplished for 48 patients. A specific etiologic diagnosis could not be established by extensive investigation of tissues submitted to the laboratory.

2. Twenty-eight had excision of single peripheral pulmonary nodules. In two instances a recurrence of a similar lesion has been observed one to six years following surgery.

3. Of the 12 with mediastinal granulomata, surgery was of benefit in eight instances. Complete excision was possible in six.

4. Eight with multinodular fibrocaseous granulomata submitted to diagnostic lung biopsy. Subsequently, they have done well with the exception of one individual thought to have pulmonary tuberculosis five years later because of acute symptoms and roentgenographic progression of disease.

5. It is probable that many of these granulomata result from subclinical or unrecognized clinical infection by known pathogenic organisms. However, some of these patients may have had an encounter with an as yet unrecognized agent. The prognosis for the majority of them is excellent. A few will develop recurrence or progression of disease months or years later.