Angioinvasive plasma cell granulomas of the lung

A series of eight plasma cell granulomas of the lung were examined. Their clinical, pathologic, and immunohistochemical characteristics as well as the ultrastructural features of one case are in agreement with those found in the literature. One patient died after a surgical intervention complicated by invasion of pulmonary veins. This led to a search for vascular injuries in the other cases. On the whole, of eight cases, two showed vascular invasions at a distance, five (including the preceding ones) showed invasion of medium-sized blood vessels in the peripheral parts of the lesion, and three showed older invasions in their center; only two had no vascular lesions. To the authors' knowledge, vascular invasion at a distance has been reported only once to date. An inflammatory origin for these cytologically benign lesions remains possible, although a striking resemblance with intravascular fasciitis can also be shown. These lesions should be treated by radical and precocious surgery.