Everything You Need to Know About Calcified Granulomas

Medically Reviewed By Marc Meth, MD, FACAAI, FAAAI
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Granulomas are clusters of white blood cells that form around inflammation in tissues. Over time, calcium deposits collect within the tissue that is healing and you can develop a calcified granuloma. Calcified granulomas are your body’s way of isolating infections to stop them from spreading.  This article will review calcified granulomas, including symptoms, causes, treatment, and prevention.

What is a calcified granuloma?

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A granuloma is a small lump of white blood cells called epithelioid histiocytes that cluster together to protect your tissues. Granulomas form when your body’s immune system fights infection, inflammation, and foreign materials.

Granulomas mostly form in the lungs. They can also form in the liver, spleen, intestines, and skin. They rarely form in blood vessels.

Calcium deposits often form in tissue that is healing. Over time, these calcium deposits can form in granulomas and the granulomas become calcified.

Calcified vs. noncalcified granulomas

Granulomas are not always calcified. Calcification is a process that happens over time. Some granulomas, particularly on the skin, can heal by themselves and calcification will not happen.

If the inflammation or infection is ongoing, calcification can happen.

Are granulomas permanent?

Depending on the underlying cause of granulomas, they can heal themselves and disappear.

Antibiotics can treat granulomas that form because of a bacterial infection in your lungs.

You can treat granulomas that form because of an inflammatory condition with corticosteroids or other anti-inflammatory medications.

In rare cases, a granuloma may not heal. The lung tissue around it can scar, and this can lead to pulmonary fibrosis.

Read more about pulmonary fibrosis here.

Is a calcified granuloma cancerous?

A calcified granuloma is rarely cancerous. Older research shows that the process of calcification generally means that the granuloma is benign.

However, your doctor may recommend followup CT scans to see whether the granuloma is growing over time. Depending on the degree of your doctor’s concern, the time between scans may range anywhere from a few months to a year.

What are the symptoms of a calcified granuloma?

Usually, there are no symptoms of calcified granulomas. If you have calcified granulomas, you may find out about them incidentally when you undergo an imaging procedure such as an X-ray or CT scan.

If there are multiple granulomas, or if they are located near the main airways of the lungs, you may have the following symptoms:

You may also have symptoms that relate to the underlying condition that leads to the formation of granulomas.

What causes calcified granulomas?

The cause of calcified granulomas can vary, including:

Bacterial infections

Tuberculosis is the most common cause of pulmonary granulomas.

Other bacteria such as Mycobacterium avium complex and Mycobacterium kansasii can also cause granulomas in the lungs.

Fungal infections

There are more than 140 types of fungal infections that can lead to lung granulomas. The most common is Cryptococcosis, which is found in soil mixed with bird feces, especially from pigeons. Other fungal infections include histoplasmosis and aspergillosis.

Autoimmune diseases

Lung granulomas can occur in some autoimmune conditions, including:

  • Sarcoidosis: This is an inflammatory disease that can affect many regions of the body and often begins with swollen glands, skin changes, fatigue, joint pain, and swelling. It can cause granulomas in the lungs and sometimes also in the liver or spleen.
  • Granulomatosis with polyangiitis: Formerly called Wegener’s granulomatosis, this can also cause granulomas.
  • Inflammatory bowel disease: Diseases such as Crohn’s disease and ulcerative colitis may lead to granulomas in the gastrointestinal tract. In less than 1% of people, they can also form in the lungs.
  • Rheumatoid arthritis: This can lead to lung granulomas as well as granulomas under the skin.

Parasites

Parasitic infections are a less common cause of granulomas in the United States, but these infections can still occur.

Environmental exposure

Certain dyes and dust from metals such as aluminum, titanium, zirconium, cobalt, and silica can lead to lung granulomas. In some cases, most often related to illicit drug use, talc can lead to granulomas.

Medications

Adverse reactions to certain medications can lead to lung granulomas. These medications include methotrexate, interferon, and the Bacillus Calmette-Guerin vaccine.

How do you diagnose calcified granulomas?

Radiologists discover most calcified granulomas incidentally when a person undergoes an X-ray or CT scan.

An experienced radiologist can diagnose the difference between noncalcified granulomas, calcified granulomas, and cancerous growths.  

Noncalcified granulomas do not contain calcium deposits. They have a diffuse appearance. Because of this, they are often misdiagnosed as cancer growths.

Calcified granulomas are denser and will therefore appear more brightly than the surrounding soft tissue on an X-ray or CT scan.

Your doctor will use a combination of clinical evaluation, laboratory testing, pulmonary function testing, and radiological imaging to reach a diagnosis.

Possible complications of calcified granulomas

An abundance of granulomas can lead to fibrosis. Fibrosis is permanent scarring that can affect the structure and the function of affected organs.

According to the Foundation for Sarcoidosis Research (FSR), 90% of chronic fibrosis affects the lungs. Fibrosis of the liver can happen when the parasitic infection schistosomiasis causes granulomas to form around the eggs of the parasite that they deposit in the liver.

How do you treat calcified granulomas?

Calcified granulomas are almost always benign. Granulomas in people who do not have any symptoms almost never require treatment. However, if you have symptoms caused by an infection, inflammation, or other reasons, your doctor will work to treat those symptoms and any underlying condition.

If you have an active bacterial or fungal infection, your doctor will prescribe the appropriate antibiotic or antifungal medication.

If your symptoms occur due to an autoimmune disorder, your doctor will provide a treatment plan for that specific disorder.

How can you prevent calcified granulomas?

There is no way to prevent calcified granulomas. Your doctor can help you to find the best treatment plan for the condition that led to them.

Do calcified granulomas go away by themselves?

Granulomas can disappear without treatment. In many people with sarcoidosis, granulomas disappear within 2–3 years.

Summary

Calcified granulomas are small clumps of immune cells that have become filled with calcium. They are usually a normal part of your body’s immune system and can appear and disappear without you becoming aware of them.

In some cases, underlying conditions cause calcified granulomas. Your doctor will work with you to treat this condition.

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Medical Reviewer: Marc Meth, MD, FACAAI, FAAAI
Last Review Date: 2022 Apr 12
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  1. Akram, S. M., et al. (2021). Mycobacterium kansasii. https://www.ncbi.nlm.nih.gov/books/NBK430906/
  2. Chronic granulomatous disease. (2016). https://medlineplus.gov/genetics/condition/chronic-granulomatous-disease/
  3. Granulomatosis with polyangiitis (Wegener's). (2021). https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Granulomatosis-with-Polyangitis-Wegners
  4. Khan, A. N., et al. (2010).The calcified lung nodule: What does it mean? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2883201/
  5. Lung nodules. (n.d.). https://www.cancer.org/cancer/lung-cancer/detection-diagnosis-staging/lung-nodules.html
  6. Naeem, M., et al. (2020). Noninfectious granulomatous diseases of the chest. https://pubs.rsna.org/doi/full/10.1148/rg.2020190180
  7. Ohshimo, S., et al. (2017). Differential diagnosis of granulomatous lung disease: Clues and pitfalls. https://err.ersjournals.com/content/26/145/170012
  8. Signs and symptoms of Crohn's disease. (n.d.). https://www.crohnscolitisfoundation.org/what-is-crohns-disease/symptoms
  9. Tomioka, H., et al. (2016). Elemental analysis of occupational granulomatous lung disease by electron probe microanalyzer with a wavelength-dispersive spectrometer: Two case reports. https://www.sciencedirect.com/science/article/pii/S221300711630034X?via%3Dihub
  10. What is sarcoidosis? (2021). https://www.stopsarcoidosis.org/what-is-sarcoidosis/