Angiocentric pulmonary granulomas in tuberculosis

An open-lung biopsy performed in a 15-year-old girl because of left sided pulmonary nodules revealed striking angiocentric necrotising granulomas. No acid fast bacilli (AFB) were cultured or demonstrated in tissue sections, however, the diagnosis of tuberculosis was suggested. Anti-tuberculous therapy resulted in both clinical and radiological cure within 12 months. The differential diagnosis of this type of lesion should include pulmonary tuberculosis as well as the non-infective angiocentric granulomas such as lymphomatoid granulomatosis and has major therapeutic implications.