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granulomas
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granulomas

by arries, Jul 22, 2004 12:00AM
I've read an article on the causes of Pulmonary Fibrosis, and under that title it had Sarcoidosis and it defined sarcoidosis as a formation of granulomas.  [American Lung Assoiciation]  It also says that fibrosis can be caused by exposure to asbestos or other small particles that causes scaring.



Is Fibrosis, granulomas, and sarcoidosis the same?



Is "old" granulomatosis disease [x-ray 1995] the same as these, and why would it say old?



Can this cause an elevated ESR and a positive ANA in 1991 and 2004?

by National Jewish, Jul 27, 2004 12:00AM
Pulmonary fibrosis is one form of interstitial lung disease (ILD).  This causes inflammation or swelling that leads to scarring or fibrosis in the interstitium of the lungs.  The interstitium is the area between the air sacs and the blood vessels.  The ultimate goal of treatment is to clear the inflammation before it leads to fibrosis.  Once fibrosis has occurred it cannot be reversed.



Sarcoidosis is a disease that causes small clusters of inflammation, called granulomas.  The granulomas can occur in any area of the body, but are most often found in the lungs, lymph nodes, eyes, and skin.  Typically sarcoidosis effects only the lungs.  When sarcoidosis effects the lungs, it can cause enlarged hilar lymph nodes.  These are in the upper middle area of the lungs.  In fact, enlargement of the hilar lymph nodes is the most common finding when sarcoidosis effects the lungs.  Adenopathy is another term for enlarged lymph nodes.  So hilar adenopathy is another way of saying the lymph nodes in the upper middle area of the lungs near the heart are larger than usual.  When the inflammation occurs in the lungs it may show up as cloudy areas on the CT scan.  Up to one half of the people with sarcoidosis improve without treatment.  This type of inflammation seldom leads to scarring or fibrosis.



A granuloma is a small cluster or nodule of inflammation that can occur in any area of the body, including the lungs.  If this inflammation leaves behind a scar this is also called a granuloma.  This inflammation could have been due to an infection in the lungs from tuberculosis or a fungus.  In certain parts of the United States fungal infections are a common cause of granulomas.  In the southwest it’s the fungus Coccidioidomycosis that causes valley fever and in the mid-west it’s the fungus Histoplasmosis.



The most common reasons for using the term "old granuloma" is to describe a granuloma that

· looks the same as it did when it was seen on a previous chest x-ray and/or,

· is calcified.



An elevated erythrocyte sedimentation rate (ESR) and anti-nuclear antibody (ANA) show that there is inflammation someplace in the body, but do not tell anything about the location.
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