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Bronchocentric granulomatosis: computed tomographic findings in five patients
S Ward1, L E Heyneman, J D Flint
1Departments of Radiology, Vancouver Hospital and Health Sciences Centre, University of British Columbia, 855 W. 12(th)Ave, Vancouver, BC, V5Z 1M9, Canada.
Aim:
The aim of this study was to assess the CT manifestations of bronchocentric granulomatosis.
Subjects And Methods:
The CT results of five patients with bronchocentric granulomatosis were retrospectively analysed. The patients ranged from 20 to 72 years of age and included three men and two women. The diagnosis of bronchocentric granulomatosis was made at lobectomy (n = 2), open lung biopsy (n = 2), and transbronchial biopsy (n = 1). Only one of the five patients had asthma.
Results:
The main findings consisted of a spiculated mass lesion (n = 3) or lobar consolidation with associated mild volume loss (n = 2). One of the two patients with consolidation had extensive mucoid impaction. The abnormalities involved predominantly an upper lobe in four patients and a lower lobe in one patient. In the four resected specimens, the macroscopic pathological appearance was consolidation (n = 2) and mass lesion (n = 2). Microscopically, the typical histology of airway-centred necrotizing granulomata was present in all cases. Aspergillus hyphae were identified in two cases. Nocardia sp. was cultured from the biopsy specimen in one case.
Conclusion:
The CT manifestations of bronchocentric granulomatosis consist of a focal mass or lobar consolidation with atelectasis. These reflect the presence of granuloma formation with or without associated bronchial obstruction.