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Cellulose Granulomatosis Presenting as Centrilobular Nodules

CT and Histologic Findings

Sandra E. Bendeck1, Ann N. Leung1, Gerald J. Berry2, Dawn Daniel3 and Stephen J. Ruoss3

1 Department of Radiology, Stanford University Medical Center, Rm. S072A, 300 Pasteur Dr., Stanford, CA 94305-5105.
2 Department of Pathology, Stanford University Medical Center, Stanford, CA 94305-5105.
3 Division of Pulmonary and Critical Care, Stanford University Medical Center, Stanford, CA 94305-5105.



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  		Fig. 1A. —36-year-old man with biopsy-proven cellulose granulomatosis. High-resolution CT images show innumerable bilateral small centrilobular nodules associated with tree-in-bud appearance (arrows). Insets show magnified views of centrilobular branching opacities in periphery of right upper and lower lobes, respectively.

 


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  		Fig. 1B. —36-year-old man with biopsy-proven cellulose granulomatosis. High-resolution CT images show innumerable bilateral small centrilobular nodules associated with tree-in-bud appearance (arrows). Insets show magnified views of centrilobular branching opacities in periphery of right upper and lower lobes, respectively.

 


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  		Fig. 1C. —36-year-old man with biopsy-proven cellulose granulomatosis. Photomicrograph of histopathologic specimen with low-power magnification shows normal pleura (arrows) and discrete nodular lesions centered on bronchovascular bundles with normal intervening lung parenchyma. (H and E, x20)

 


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  		Fig. 1D. —36-year-old man with biopsy-proven cellulose granulomatosis. Photomicrograph of histopathologic specimen shows branching muscular pulmonary artery with distal dilatation and luminal occlusion by foreign material and associated reaction. (elastica-van Gieson, x100)

 


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  		Fig. 1E. —36-year-old man with biopsy-proven cellulose granulomatosis. Photomicrograph of histopathologic specimen shows nodules containing optically active material under polarizable light. (H and E, x40)

 

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