Help! What do I do with those Granulomas in the Lung?


Granulomatous lung disease is a common problem in surgical pathology and the differential is broad. When stains and cultures are negative, one needs an approach to guide clinical decision making. The lecture will highlight a practical, proven approach to interpreting large and small granulomas in a way that will be most helpful to your clinicians and patients.

Originally presented on February 10, 2019 in Park City, Utah.

Lecture Presenter

Henry D. Tazelaar, MD

Henry D. Tazelaar, MD

Professor of Laboratory Medicine and Pathology
Consultant, Department of Laboratory Medicine and Pathology
Mayo Clinic in Arizona

Dr. Henry Tazelaar is Chair of the Department of Laboratory Medicine and Pathology at Mayo Clinic in Arizona, and he is a Consultant in the Division of Anatomic Pathology in Arizona. Dr. Tazelaar also serves as Chair of the Laboratory Medicine and Pathology Specialty Council. He joined the staff of Mayo Clinic in 1988 and holds the academic rank of Professor of Laboratory Medicine and Pathology.

Dr. Tazelaar earned his Bachelor of Arts degree at Calvin College in Grand Rapids, Michigan, and his M.D. at Rush Medical College in Chicago. He completed both an internship and residency in pathology at Stanford University Medical Center, followed by a National Institutes of Health postdoctoral fellowship in the pathology of heart-lung transplantation in the laboratory of Dr. Margaret Billingham at Stanford University Medical Center, where he subsequently completed a fellowship in surgical pathology.

Dr. Tazelaar’s work has focused on refining criteria used to diagnose the rejection of transplanted hearts and lungs. He is also active in identifying new pulmonary diseases and better understanding how systemic diseases affect the lungs and pleura. His observations have led to the identification of several new or unusual pulmonary diseases.

Clinically, Dr. Tazelaar is a surgical pathologist, a role that includes a large thoracic consultation practice offering second opinions on biopsy and cytology specimens. He is also an active educator, providing mentorship to a multitude of residents and fellows. In addition, he has taught in the Cytotechnology Program of the Mayo Clinic School of Health Sciences and Mayo Clinic School of Medicine.

Dr. Tazelaar is a fellow of the American College of Chest Physicians and College of American Pathologists, where he is a member of the Pulmonary and Mediastinum Tumors Cancer Protocol Review Panel. He is active in many other professional organizations, serving on numerous committees and in leadership roles, including a tenure as president of the Pulmonary Pathology Society. He was also a member of the International Society for Heart and Lung Transplantation groups that standardize reporting of heart and lung rejection. Dr. Tazelaar is currently Treasurer of the International Academy of Pathology and Chair of the Finance Committee of the United States and Canadian Academy of Pathology.


After this presentation, participants will be able to:

  • Identify a framework for approaching cases with granulomatous inflammation, both large and small
  • List the features of granulomas associated with infection
  • List the features of granulomas which favor a vasculitic process i.e. granulomatosis with polyangitiis
  • Discriminate between foreign material and endogenous inclusions in the lung

Sponsored by:

University of Utah School of Medicine, Department of Pathology, and ARUP Laboratories