12
Diagnosis
Table 3. Key Infectious and Noninfectious Differential
Diagnoses for Granulomatous Lesions within
Commonly Biopsied Sites
Exposures
Hypersensitivity pneumonitis
a
Ｘ Ｘ
Hot tub lung syndrome
(MAC exposure with
hypersensitivity features)
Ｘ Ｘ
Pneumoconiosis (such
as beryllium, titanium,
aluminum, zirconium, cobalt,
and others)
Ｘ Ｘ Ｘ
Drug-induced granulomatous
disease (including but not
limited to IFN, checkpoint
inhibitor, anti-TNF, and/or
biologic therapies)
a
Ｘ Ｘ Ｘ Ｘ Ｘ
Foreign body granulomatosis
(such as talc aspirate or
injected, tattoo ink)
a
Ｘ Ｘ Ｘ
Steatosis (lipogranulomas)
Ｘ
Idiopathic
Sarcoidosis
Ｘ Ｘ Ｘ Ｘ Ｘ
Necrotizing sarcoid
granulomatosis
Ｘ Ｘ
Histiocytic necrotizing
lymphadenitis (Kikuchi's
disease)
Ｘ
GLUS
Ｘ Ｘ Ｘ Ｘ
Bronchocentric
granulomatosis
Ｘ
a
More commonly found alternative diagnoses for granulomatous disease in U.S. populations.
e differential diagnosis should be prioritized on the basis of the individual's clinical history
and presentation.
