- Talmadge E King, Jr, MD
Talmadge E King, Jr, MD
- Editor-in-Chief — Pulmonary and Critical Care Medicine
- Section Editor — Interstitial Lung Disease
- Dean, School of Medicine
- Vice Chancellor, Medical Affairs
- University of California San Francisco
Bronchocentric granulomatosis is a destructive, granulomatous lesion of the bronchi and bronchioles that is generally believed to represent a nonspecific response to a variety of types of airway injury [1-3]. Approximately half of all cases are associated with asthma and allergic bronchopulmonary aspergillosis (ABPA), and among these patients, bronchocentric granulomatosis may represent a histopathologic manifestation of fungal hypersensitivity [3-7]. (See "Clinical manifestations and diagnosis of allergic bronchopulmonary aspergillosis".)
The remaining cases of bronchocentric granulomatosis are usually idiopathic, although associations have been reported with a number of other diseases (table 1) [3,8-24]. Because of the lack of a clear clinical syndrome associated with bronchocentric granulomatosis, the presence of this lesion should generally be considered a nonspecific manifestation of lung injury, not an etiologic diagnosis.
An overview of bronchocentric granulomatosis will be presented here. Pulmonary lymphomatoid granulomatosis, a different clinicopathological entity usually related to Epstein-Barr virus-associated lymphoma, and an approach to an adult with suspected interstitial lung disease, are discussed separately. (See "Pulmonary lymphomatoid granulomatosis" and "Approach to the adult with interstitial lung disease: Clinical evaluation" and "Approach to the adult with interstitial lung disease: Diagnostic testing".)
Bronchocentric granulomatosis is rare, although the exact incidence and prevalence are unknown.
A number of diseases have been reported in association with bronchocentric granulomatosis, although the relationship of the association is unclear. The largest association is with allergic bronchopulmonary aspergillosis (ABPA). Case reports have described coexistent mycobacterial and fungal infection, rheumatoid arthritis, ankylosing spondylitis, granulomatosis with polyangiitis (Wegener's), chronic granulomatous disease, glomerulonephritis, scleritis, diabetes insipidus, red cell aplasia, pulmonary echinococcosis, bronchogenic carcinoma, and influenza A virus (table 1) [3,8-25].To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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