Granulomatous lung diseases encompass a diverse group of disorders defined by the presence of pulmonary granulomas. This is a heterogeneous group of disorders that has a wide spectrum of pathologies with varying clinical manifestations and outcomes. Granulomatous lung diseases are divided into infectious and non-infectious lung diseases. Infectious diseases include mycobacterial (pulmonary tuberculosis) and fungal infections.
Although tuberculosis (TB) is often perceived as a disease of the past, it still represents a significant global public health problem due to high prevalence, mortality, increasing resistance to antituberculous drugs, and frequent association with immunocompromised conditions. Modern therapeutic approaches, including shortened treatment regimens for drug-sensitive TB and new options for treating resistant forms of the disease, have significantly improved treatment possibilities.
The most common non-infectious granulomatous lung diseases include sarcoidosis, hypersensitivity pneumonitis, autoimmune diseases and vasculitis, pneumoconioses, and Langerhans cell histiocytosis.
Since the granuloma is a nonspecific pathological histological finding, a multidisciplinary approach is important for a reliable diagnosis. Careful clinical evaluation, laboratory testing, pulmonary function testing, and radiological imaging, including high-resolution computed tomography, are key steps in the diagnostic approach to granulomatous lung disease.
In most cases, a lung biopsy with pathological histological examination of lung tissue samples is necessary. Bronchoalveolar lavage, endobronchial ultrasound-guided transbronchial needle aspiration, transbronchial cryobiopsy, positron emission tomography, and genetic assessment contribute to improving the diagnostic accuracy of granulomatous lung diseases.
Treatment is highly variable and depends on the underlying cause. For infectious causes of granulomatous diseases, antimicrobial agents are used, while in non-infectious cases, avoidance of the causative antigen in hypersensitivity pneumonitis, the use of corticosteroids, and immunosuppressive drugs for sarcoidosis, hypersensitivity pneumonitis, and autoimmune granulomatous diseases are recommended. In progressive forms, antifibrotics are used, and sometimes lung transplantation.
This year, on September 25, 2026, the traditional National Vojvodina Pulmonology Symposium will be held at the Institute for Lung Diseases of Vojvodina on the topic “GRANULOMATOUS LUNG DISEASES IN DAILY CLINICAL PRACTICE,” which will bring together experts in the fields of pulmonology, pathology, radiology, bronchoscopy, and microbiology, who will present and lead discussions on the latest diagnostic and therapeutic achievements related to granulomatous lung diseases.
For more information about the symposium and the complete schedule of lectures, download the document.
Literature:
Lassandro G, Picchi SG, Corvino A, Massimo C, Tamburrini S, et al. Noninfectious Granulomatous Lung Disease: Radiological Findings and Differential Diagnosis. J Pers Med. 2024;14(2):134.
Butler, Daniel SC. “Re-defining granulomas: bacterial effectors, host circuits, and spatially resolved immunity.” Journal of Leukocyte Biology (2026).
Global tuberculosis report 2025. Geneva: World Health Organization; 2025.
Wells, Athol U., et al. “A paradigm shift in corticosteroid therapy for sarcoidosis: a World Association of Sarcoidosis and Other Granulomatous Disorders Position Paper, endorsed by the Americas Association of Sarcoidosis and Other Granulomatous Disorders.” The Lancet Respiratory Medicine (2026): 363–374.
Butler, Daniel SC. “Re-defining granulomas: bacterial effectors, host circuits, and spatially resolved immunity.” Journal of Leukocyte Biology (2026).