Bronchocentric Granulomatosis

Abstract

A 42 years old male patient developed acute cough with fever and severe wheezing. he was non-asthmatic, non-smoker, and not exposed to Asbestos. Clinical investigation indicated acute organizing pneumonia in the left lower lobe without sign of response to applied antibiotic treatment. Resection of the lower left lobe war performed. A circumscribed lesion measuring 25 mm in mximum diameter displayed microscopic with centrally necrotized bronchi of medium and larger size surrounded by chronic lymphocytic granulomatous inflammatory infiltrates. No verification of fungus, tuberculosis or parasites in the suitable stains. Normal count of asbestos fibers (5 fibers/gr wet tissue). Expression of galectin 1, 3, 8 and their binding sites only in the affected bronchi in accordance with inflammatory changes, i.e., only secondary involvement of peripheral lung tissue. Post surgical evaluation of the patient's history revealed an infection of Saccharomyces carlsbergensis, Schizosaccharomyces pombe and Dictyostelium discoideum. Saccharomyces carlsbergensis is a known to be saprocyte in the sputum of patients displaying with infections of the lower airways, and it might be considered as participating factor in the development of bronchocentric granulomatosis. The post surgical follow up of the patient was inconspicuous. Differential diagnosis: Aspiration, Pneumocistis carinii pneumonia, Tuberculosis, Aspergillosis