Challenges in the differential diagnosis of granulomatous lung disease

Introduction. Granulomatous lung diseases comprise a large family sharing the histological denominator of granuloma formation. Review of literature. From a diagnostic standpoint, epithelioid granulomas, are considered to be nonspecific lesions, they can be associated with infection, immunological conditions or they may be idiopathic. The precise diagnosis of granulomatous disorders can be readily apparent on clinical and radiological ground alone in some cases or extremely difficult even after histological examination of large surgical samples in a limited number of conditions. No single and specific diagnostic test has been developed so far. To achieve a timely diagnosis and help reduce associated morbidity and mortality, it is essential to recognize both the typical and the atypical manifestations of the disease. Differential diagnosis and management demand a skilful interpretation of clinical findings and pathological evidence. Conclusion. A clinicopathological synthesis provides the strongest foundation.