{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,19]],"date-time":"2026-04-19T21:16:03Z","timestamp":1776633363027,"version":"3.51.2"},"reference-count":16,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2014,10,29]],"date-time":"2014-10-29T00:00:00Z","timestamp":1414540800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Respirology"],"published-print":{"date-parts":[[2015,1]]},"abstract":"Abstract<\/jats:title>Background and objective<\/jats:title>Granulomatous lung disease (GLD<\/jats:styled-content>) is caused by a wide range of conditions. Often there is a need to correlate pathological findings with clinical, microbiological or radiological data to determine an aetiology. The aim of this study was to determine the different aetiologies of GLD<\/jats:styled-content> over the past decade.<\/jats:p><\/jats:sec>Methods<\/jats:title>Among 2228 consecutive lung specimens from 1999 to 2011, 226 cases (10.1%) were positive for GLD<\/jats:styled-content>. One hundred ninety patients were retrospectively reviewed and diagnoses were assigned based on availability of histological\/clinical\/microbiological correlation.<\/jats:p><\/jats:sec>Results<\/jats:title>A confident, probable and uncertain diagnosis was made in 68.4%, 13.2% and 18.4% patients. The aetiologies comprised infectious, non\u2010infectious and uncertain in 54.7%, 26.8% and 18.4% patients. Mycobacterial infections constituted 27% of all patients, and included atypical, tuberculous and unclassified mycobacteria in order of frequency. Acid\u2010fast bacilli (AFB) were visualized in tissue sections in 29% cases and cultured in 73% cases. Fungal infections comprised 27% of all cases, which included C<\/jats:italic><\/jats:styled-content>occidioides<\/jats:italic>, C<\/jats:italic><\/jats:styled-content>ryptococcus<\/jats:italic>, A<\/jats:italic><\/jats:styled-content>spergillus<\/jats:italic> and H<\/jats:italic><\/jats:styled-content>istoplasma<\/jats:italic> in order of frequency. Fungi were visualized in tissue sections with Gomori methenamine silver (GMS<\/jats:styled-content>) stain in 83% patients and cultured in 52% cases. Sarcoidosis was the major non\u2010infectious aetiology, constituting 21% of all patients. Necrosis in granulomas was associated with the presence of infection (P<\/jats:italic>\u2009<\u20090.001).<\/jats:p><\/jats:sec>Conclusions<\/jats:title>The aetiology in necrotizing GLD<\/jats:styled-content> with negative AFB<\/jats:styled-content> and GMS<\/jats:styled-content> stains is most likely infectious due to atypical mycobacteria. Coccidioidomycosis was the most common fungal infection. The aetiology in non\u2010necrotizing GLD<\/jats:styled-content> is most likely non\u2010infectious, probably sarcoidosis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/resp.12410","type":"journal-article","created":{"date-parts":[[2014,10,29]],"date-time":"2014-10-29T07:02:25Z","timestamp":1414566145000},"page":"115-121","source":"Crossref","is-referenced-by-count":30,"title":["Incidence and aetiologies of pulmonary granulomatous inflammation: A decade of experience"],"prefix":"10.1111","volume":"20","author":[{"given":"Alia","family":"Nazarullah","sequence":"first","affiliation":[{"name":"Department of Pathology University of Texas Health Science Center at San Antonio San Antonio Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Nilson","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Texas Health Science Center at San Antonio San Antonio Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diego Jose","family":"Maselli","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Diseases and Critical Care Department of Medicine University of Texas Health Science Center at San Antonio San Antonio Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaishree","family":"Jagirdar","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Texas Health Science Center at San Antonio San Antonio Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,10,29]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.06.00112205"},{"key":"e_1_2_6_3_1","first-page":"164","article-title":"The granulomatous inflammatory response. A review","volume":"84","author":"Adams DO","year":"1976","journal-title":"Am. J. Pathol."},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2559.2006.02546.x"},{"key":"e_1_2_6_5_1","first-page":"181","article-title":"Granulomatous diseases of the lung that mimic respiratory infections","volume":"3","author":"Marinelli WA","year":"1988","journal-title":"Semin. Respir. Infect."},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/jclinpath-2011-200336"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000478-198203000-00004"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e3181ef9fa0"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1959.03010050009002"},{"key":"e_1_2_6_10_1","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1097\/00000478-198004010-00002","article-title":"Solitary necrotizing granulomas of the lung: differentiating features and etiology","volume":"4","author":"Ulbright TM","year":"1980","journal-title":"Am. J. Surg. Pathol."},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.9.2.177"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2010.300030"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid0203.960305"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00027-06"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0272-5231(03)00138-2"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1529-8019.2009.01263.x"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.12-2113"}],"container-title":["Respirology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fresp.12410","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/resp.12410","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,30]],"date-time":"2023-09-30T00:28:41Z","timestamp":1696033721000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/resp.12410"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,10,29]]},"references-count":16,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2015,1]]}},"alternative-id":["10.1111\/resp.12410"],"URL":"https:\/\/doi.org\/10.1111\/resp.12410","archive":["Portico"],"relation":{},"ISSN":["1323-7799","1440-1843"],"issn-type":[{"value":"1323-7799","type":"print"},{"value":"1440-1843","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,10,29]]}}}