Progressive bronchocentric granulomatosis: case report.

Bronchocentric granulomatosis was first described in 19731 and is characterised by a necrotising granulomatous destruction of bronchial walls, bronchioles, and adjacent lung parenchyma. The bronchial lumen is filled by debris and cells, predominantly eosinophils in asthmatic patients and polymorphonuclear leucocytes in non-asthmatic patients.2 Proximal bronchi may show severe chondritis. Any vascular lesions are secondary to the bronchial disease.3 The aetiology of bronchocentric granulomatosis in nonasthmatic patients is obscure; but in asthmatic patients fungi may be isolated, and Katzenstein4 suggests that bronchocentric granulomatosis is one pathological expression of the clinical syndrome allergic bronchopulmonary aspergillosis. Despite the high incidence of allergic bronchopulmonary aspergillosis in Britain the only reference to bronchocentrice granulomatosis in British reports is a personal communication from Hinson.' We present a case of bronchocentric granulomatosis in a British woman who had never travelled abroad.