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Bronchocentric granulomatosis
Other Resources UpToDate PubMed

Bronchocentric granulomatosis

Contributors: Casey Silver MD, Mary Anne Morgan MD, Michael W. Winter MD
Other Resources UpToDate PubMed


Bronchocentric granulomatosis is a rare disease characterized by necrotizing granulomatous inflammation beginning in and centering around the bronchiolar walls. The inciting inflammatory precipitant is often unclear. It is associated with numerous diseases of infectious and autoimmune etiologies. These include rheumatoid arthritis; viral, fungal, and mycobacterial infections; diabetes insipidus; ankylosing spondylitis; and systemic granulomatous diseases. Bronchogenic carcinoma has also been described in association with bronchocentric granulomatosis.

Symptoms include fever, cough, wheezing, dyspnea, and blood eosinophilia. Approximately half of patients are asthmatic, and the disease can be associated with Aspergillus fumigatus hypersensitivity or infection.

Related topics: Aspergillosis, Allergic bronchopulmonary aspergillosis


J98.09 – Other diseases of bronchus, not elsewhere classified

111901001 – Bronchocentric granulomatosis

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Cryptogenic organizing pneumonia
  • Allergic bronchopulmonary aspergillosis – biopsy will show eosinophilic infiltration
  • Follicular Bronchiolitis
  • IgG4-related disease – will see plasma cell infiltration with positive IgG4 immunostaining
  • Lymphomatoid granulomatosis
  • Vasculitis
  • Granulomatosis with polyangiitis (Wegener granulomatosis)
  • Necrotizing sarcoid granulomata

Best Tests

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Last Reviewed:06/12/2019
Last Updated:06/16/2019
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Bronchocentric granulomatosis
A medical illustration showing key findings of Bronchocentric granulomatosis : Cough, Fatigue, Eosinophilia, IgE elevated, Malaise, Pleuritic chest pain, Dyspnea
Copyright © 2024 VisualDx®. All rights reserved.