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A retrospective analysis was conducted on a clinical case of pulmonary granuloma in a patient presenting with cough, sputum production, and hemoptysis. Initial computed tomography imaging revealed a malignant lung tumor. However, trans-thoracoscopy indicated that the lesion was an inflammatory granuloma, and the final diagnosis confirmed this finding. This case emphasizes that symptoms such as cough, sputum production, and hemoptysis may be indicative of pulmonary granulomas and may be misdiagnosed as malignant lung tumors. Therefore, a systematic and comprehensive diagnostic approach is essential. 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