Bronchocentric granulomatosis and ankylosing spondylitis.

Development of pulmonary fibrocystic disease in the upper lobes is a well recognised extraskeletal manifestation of ankylosing spondylitis but its pathogenesis is obscure.' 2 Although pulmonary fibrosis may occur in association with other collagen vascular diseases, a predilection for the upper lobes is unique to ankylosing spondylitis. The fibrocystic disease is usually asymptomatic; if symptoms develop, they are usually due to superimposed colonisation or infection by fungi or mycobacteria.' -3 In this report we describe a patient with ankylosing spondylitis and apical fibrocystic disease, who developed a progressive left upper lobe cavitating infiltrate with haemoptysis and was found to have bronchocentric granulomatosis.