Bronchocentric granulomatosis (BG) is a rare chronic condition involving the lung and is sometimes included in the spectrum of eosinophilic lung disease 7.
It can affect a wide age spectrum of patients but is thought to peak between the 4th to 7th decades 6.
Its underlying cause is often unclear.
It is characterised by a necrotizing granulomatous inflammation of bronchial and bronchiolar epithelium with chronic inflammatory changes in the surrounding lung parenchyma.
The current pathogenetic mechanism is considered to be an immunologic reaction against endobronchial antigens 3.
Approximately one-third to half of affected patients have tissue eosinophilia and tend to have a combination of asthma, peripheral eosinophilia, fungal hyphae at biopsy, and positive sputum cultures for Aspergillus organisms.
Other rare reported associations include
- rheumatoid arthritis - see - pulmonary manifestations of rheumatoid arthritis 8
CT - HRCT
CT features of bronchocentric granulomatosis are non-specific and can include a focal mass or lobar consolidation with atelectasis.
Treatment and prognosis
It is usually treated with short-term corticosteroids and tends to have a favourable overall prognosis 4. Some case may resolve spontaneously 6.
It is thought to have been initially described by Liebow et al. in 1973 6.
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- 7. Jeong YJ, Kim KI, Seo IJ et-al. Eosinophilic lung diseases: a clinical, radiologic, and pathologic overview. Radiographics. 27 (3): 617-37. doi:10.1148/rg.273065051 - Pubmed citation
- 8. Bes C, KıLıçGüN A, Talay F et-al. Bronchocentric granulomatosis in a patient with rheumatoid arthritis. Rheumatol. Int. 2012;32 (10): 3261-3. Rheumatol. Int. (full text) - doi:10.1007/s00296-010-1495-1 - Pubmed citation