Bronchocentric granulomatosis (BG), which was first described by Liebow in 1973 (1), is a destructive granulomatous lesion, which forms in response to airway damage to the bronchi and bronchioles.
Bronchocentric granulomatosis has no specific clinical, immunological, and radiological findings, and the definite diagnosis can be made only by performing a histopathological examination.
Corticosteroid monotherapy in a case of bronchocentric granulomatosis with a two-year follow-up.
The Splendore-Hoeppli phenomenon itself is not specific for basidiobolomycosis  and can also be observed in other infections, such as botryomycosis  bronchocentric granulomatosis
due to Aspergillus  mycetoma  and Pityrosporum folliculitis skin infection , although the combination of the clinical presentation, the Splendore-Hoeppli phenomenon, and septate hyphae suggests basidiobolomycosis.
Numerous other so-called minor manifestations of GPA have been described, including interstitial fibrosis, lipoid pneumonia, chronic bronchiolitis, follicular bronchiolitis, and bronchocentric granulomatosis
. (35) Surgical lung biopsies may not show all the required histologic features, and correlation with clinical and serologic data is often needed to arrive at a definitive diagnosis of GPA.
(82) Hypersensitivity to the fungus results in a distinctive tissue reaction characterized by the triad of mucoid impaction of bronchi, bronchocentric granulomatosis, and eosinophilic pneumonia (Figure 4, A through D).
Several entities enter the differential diagnosis, including (1) other forms of Aspergillus lung disease; (2) mucoid impaction of bronchi, bronchocentric granulomatosis, or eosinophilic pneumonia, occurring in isolation; and (3) diseases due to other fungi with septate hyphae.
Bronchocentric granulomatosis refers to the presence of necrotizing granulomas centered exclusively on bronchi and bronchioles.
Potential Etiologies of Acute and Chronic Bronchiolitis (a) Viral infection Bacterial infection Mycoplasma infection Hypersensitivity pneumonitis Respiratory bronchiolitis Aspiration pneumonia Pulmonary involvement with collagen vascular disease Posttransplantation, graft-versus-host disease Wegener granulomatosis Bronchocentric granulomatosis
Diffuse panbronchiolitis Inhalation of fumes and toxins Asthma Inflammatory bowel disease-related small airways disease Idiopathic (a) Data were derived from Cagle et al.
Bronchocentric granulomatosis (BCG), first described by Liebow in 1973, consists of filling of the lumen of a bronchiole with dense plugs of mucus and cellular debris, necrosis of mucosa, and its replacement by polymorphous inflammation and radially palisaded epithelioid histiocytes.
Bronchocentric granulomatosis can present radiologically as a single mass, as multiple masses, or as a more diffuse disease.
(*) BCG indicates bronchocentric granulomatosis; BAC, bronchioloalveolar cell carcinoma; MD, moderately differentiated; LCC, large cell carcinoma; U, undifferentiated; SCC, squamous cell carcinoma; AC, adenocarcinoma; and N, negative.