Granulomatous Lung Disease. Disease for Pulmomologists: Diagnosis and Treatment

Granuloma, a collection of various inflammatory cells composed of lymphocytes, epithelioid cells, giant cells, mononuclear cells, eosinophils, plasma cells, and fibroblasts is a host response to an antigen(s). Specific patterns of the granulomatous response such as necrosis, caseation, and the presence or absence of microorganisms or foreign bodies aid in securing the diagnosis. The common causes of granulomatous lung disease include sarcoidosis, hypersensitivity pneumonitis, Wegener's granulomatosis, mycobacterial infections, fungal diseases, parasitic infestations, and drugs. This review, designed for practicing pulmonologists, emphasizes diagnosis and treatment of some of the common pulmonary granulomas.