Abstract： Objective It is difficult to clarify the final diagnosis of patients who are proved to he with pulmonary granuloma by biopsy.This study ought to search the pattern of diagnosis means by analyzing the patients with pulmonary granuloma.Methods Seventy-three patients who were proved to be with pulmonary granuloma by biopsy were collected.The following items were observed:constituent ratios of final diagnosis,clinical features,radiology,lung pathology and special stain,sensitivity and specificity of serum diagnostic test.Results Patients with pulmonary infectious diseases accounted for 54.8%(40/73)of all the cases.Fugal infection was the common factor,accounted for 80% of infectious diseases.Sarcoidosis accounted for 38.4%.There was little specificity to clarify the diagnosis by clinical features.46.6% of Cryptococcus neoformans and 42.9% of sarcoidosis patients had no subjective symptom.Air crescent and halo sign in high resolution CT were special for pulmorlary aspergillus infection.Hematoxylin and eosin stain and special stain with lung tissues were very important to clarify the diagnosis.Fungal antigens such as galactomannan and latex agglutination test had high sensitivity and specificity for diagnosing fungal infections.Conclusions The final diagnosis is a colligation of all factors.Integrated the clinical microorganism detection,serum fungal antigens,lungs pathology and their special stains are important for clarifying diagnosis.