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Reversed halo sign in lymphomatoid granulomatosis

Departments of ¹ Medical Imaging, ² Pathology, ³ Thoracic Surgery and ⁴ Respirology, Toronto General Hospital, NCSB, 1C- 571, 585 University Avenue, Toronto, Ontario, M5G 2N2, Canada

Correspondence: Dr Rachel E Benamore, Department of Medical Imaging, Toronto General Hospital, NCSB, 1C-571, Toronto, M5G 2N2, Canada. E-mail: rachelbenamore{at}doctors.org.uk

Lymphomatoid granulomatosis is a rare lymphoproliferative disorder which affects extranodal sites, most commonly lung. Radiologically, it typically presents with multiple nodular opacities that may wax and wane. The reversed halo sign has previously been reported in cryptogenic organizing pneumonia and more recently in South American blastomycosis. We describe a case of histologically proven lymphomatoid granulomatosis in a patient who presented initially with the more typical nodular opacities, which subsequently progressed into the reversed halo sign. To the best of our knowledge, this association has not been previously described.

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