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This report concerns a patient with lymphomatoid granulomatosis who presented with multiple ulcerated skin nodules, a solitary pulmonary mass and a cerebral mass. Biopsies taken from the skin and lung lesion showed necrotic tissue only. This combination of physical signs and the initial non-specific histological changes suggested a diagnosis of primary bronchial carcinoma with secondary spread. However, the subsequent temporary improvement and a further histological examination enabled a diagnosis of lymphomatoid granulomatosis to be made and this was confirmed at post-mortem. This report emphasizes the difficulty in obtaining diagnostic material in lymphomatoid granulomatosis and highlights the need to consider this diagnosis in a patient with suspected carcinoma when biopsy material shows necrotic tissue only.
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