ABSTRACT Hypertrophic pachymeningitis (HP) is a rare chronic fibro-inflammatory process that leads to thickening of the dura mater in the central nervous system. It might be idiopathic or secondary to several causes including infections, malignancy, autoimmune conditions or sarcoidosis. Pulmonary involvement in HP is a rare association that poses a diagnostic dilemma, particularly as to whether the pathologic process is idiopathic or secondary to another systemic disorder. The case of a 50-year-old woman with HP and recurrent pulmonary infiltrates is presented with a discussion on the systematic diagnostic approach and management of relapses. Although pulmonary involvement in secondary HP is well recognized, it can occur rarely in the idiopathic type. The pathogenetic mechanisms are likely related to a systemic immune process that deserves further research.
Mobeireek et al. (Mon,) studied this question.
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