Bronchocentric granulomatosis: Computed tomographic findings in five patients

AIM: The aim of this study was to assess the CT manifestations of bronchoce ntric granulomatosis. SUBJECTS AND METHODS: The CT results of five patients with bronchocentric g ranulomatosis were retrospectively analysed. The patients ranged from 20 to 72 years of age and included three men and two women. The diagnosis of bro nchocentric granulomatosis was made at lobectomy (n = 2), open lung biopsy (n = 2), and transbronchial biopsy (n = 1). Only one of the five patients h ad 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 t wo patients with consolidation had extensive mucoid impaction. The abnormal ities involved predominantly an upper lobe in four patients and a lower lob e in one patient. In the four resected specimens, the macroscopic pathologi cal appearance was consolidation (n = 2) and mass lesion (n = 2). Microscop ically, the typical histology of airway-centred necrotizing granulomata was present in all cases. Aspergillus hyphae were identified in two cases. Noc ardia 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 obstru ction. (C) 2000 The Royal College of Radiologists.