Pulmonary plasma cell granuloma improves with corticosteroid therapy.

Two cases of pulmonary plasma cell granuloma that progressed after respiratory infectious disease are described. The men, 48 and 32 years old, were admitted to the hospital with blood-streaked sputum and mass or nodular shadow on chest radiograph. Close examination revealed that these tumors were plasma cell granulomas, which are known as postinflammatory pseudotumors. Biopsy specimens, obtained by way of transbronchial biopsy, demonstrated proliferation of mature plasma cells and infiltration of lymphocytes supported by granulation tissue, and there was no evidence of malignancy or tuberculosis. Although surgery is common in the treatment of pulmonary plasma cell 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. Two or 4 weeks later, these tumors disappeared completely and they have never recurred. As middle-dosage corticosteroid therapy is not cytotoxic, it is useful for the treatment of pulmonary plasma cell granuloma, especially in multifocal, unresectable, and/or relapsing cases.