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Granulomatous inflammation (non-infectious)

Bronchocentric granulomatosis

Reviewers: Elliot Weisenberg, M.D. (see Reviewers page)
Revised: 24 September 2011, last major update September 2011
Copyright: (c) 2003-2011, PathologyOutlines.com, Inc.


● Granulomatous disease of lungs in which almost all granulomas are centered in bronchi or bronchioles causing their destruction
● Immunologic reaction related to chronic eosinophilic pneumonia and allergic bronchopulmonary aspergillosis
● A histologic pattern of disease, not a specific diagnosis
● Usually adults, often with asthma history and limited to lungs, may be asymptomatic
● Usually solitary lesions that appear on chest X-ray as atelectasis or consolidation, not nodules
● Generally favorable prognosis

Gross description

● Viscous material in involved bronchi

Micro description

● Large and medium bronchi infiltrated by neutrophils, eosinophils and necrotic debris surrounded by foreign body giant cells
● Fragmented elastic tissue (with elastic stain)
● Also bronchiolitis obliterans
● No fibrinoid necrosis of vessels

Differential Diagnosis

Wegener granulomatosis: kidney involvement, may also have bronchocentric granulomas
Rheumatoid arthritis:
Fungi: can identify orgqanisms with silver stain
Cystic fibrosis: different clinical history

End of Lung-nontumor > Granulomatous inflammation (non-infectious) > Bronchocentric granulomatosis

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