- With Mayo Clinic emeritus internist
Edward C. Rosenow III, M.D.
read biographyclose windowBiography of
Edward C. Rosenow III, M.D.
Edward Rosenow, M.D.
Dr. Edward Rosenow III spent his entire professional career at Mayo Clinic, retiring after 31 years. He was born in Ohio and obtained his M.D. at Ohio State University. Prior to his retirement, he was the Arthur M. and Gladys D. Gray Professor of Medicine.
He has achieved numerous awards and honors, including the Mayo Fellows Hall of Fame of Outstanding Teachers, president of the Mayo staff, president of the American College of Chest Physicians, Distinguished Mayo Clinician Award, an honor lectureship in his name given each year at the annual meeting of the American College of Chest Physicians, the Mayo Foundation Distinguished Alumnus Award, and most recently the Edward C. Rosenow III, M.D., Professorship in The Art of Medicine by the Bruce Clinton family. He recently received the Mayo Plummer Society Award for Excellence in Medicine.
"It has always been my feeling that the better informed the patient is about his or her body and its functions, the better the patient-physician partnership," he says. "The informed patient is in turn more compliant with the physician's recommendations and better able to make intelligent decisions about health care needs."
He was chairman of the Division of Pulmonary and Critical Care Medicine. He is a Master Fellow of the American College of Physicians and the American College of Chest Physicians. He considers the Karis ("caring" in Greek) Award from Mayo Clinic as one of his most cherished awards, because he learned over the years that many times the gift of caring and compassion are more effective in healing than the powers of modern medicine. As a result of this award he wrote a book, "The Art of Living … The Art of Medicine," about how medicine should be practiced.
Dr. Rosenow has contributed to more than 170 publications, including over 30 book chapters, two books, two co-authored books and four amici curiae for the U.S. Supreme Court on tobacco legislation.
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Question
Granuloma: What does it mean?
My mother-in-law recently had a chest X-ray and was told she has a granuloma in her lung. What does that mean?
Answer
from Edward C. Rosenow III, M.D.
A granuloma is a small area of inflammation in tissue. Granulomas are most often the result of an infection and most frequently occur in the lungs, but can occur in other parts of the body as well. They typically cause no signs or symptoms and are found incidentally on a chest X-ray done for some other reason.
The most common cause of lung granulomas in the United States is histoplasmosis, a fungal infection that primarily affects the lungs. People who acquire pulmonary histoplasmosis that results in a lung granuloma have almost always spent some time in the Ohio Valley or the upper Midwest. Most people with pulmonary histoplasmosis never suspect they have the disease because signs and symptoms are rare.
Although granulomas due to histoplasmosis are noncancerous (benign), they may resemble cancer on an X-ray, especially if they haven't calcified — over time, granulomas become calcified and have the same density as bone, making them more clearly visible on an X-ray.
A doctor may make a diagnosis of granuloma by chest X-ray or, if the granuloma is not apparently calcified, by computerized tomography (CT), which can detect the calcium that isn't evident on the chest X-ray. The images of affected tissue usually show scarring and calcification characteristic of a granuloma. Granulomas almost never require treatment or even follow-up chest X-rays.
- Dorland's Illustrated Medical Dictionary. 32nd ed. Philadelphia, Pa.: W.B. Saunders; 2011. http://dorlands.com/index.jsp. Accessed Aug. 17, 2012.
- Wheat LJ, et al. Pathogenesis and clinical features of pulmonary histoplasmosis. http://www.uptodate.com/home/index. Accessed Aug. 17, 2012.
- Mukhopadhyay S, et al. Granulomatous lung disease: An approach to the differential diagnosis. Archives of Pathology and Laboratory Medicine. 2010;134:667.
- Mukhopadhyay S, et al. Causes of pulmonary granulomas: A retrospective study of 500 cases from seven countries. Journal of Clinical Pathology. 2012;65:51.
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