Granulomas in the lungs are mostly suggestive of tuberculosis and autoimmune diseases. Granulomas in the lungs caused by tuberculosis mostly present with cough, little sputum,, hot flashes, night sweats, even blood in the sputum, and progressive wasting. Granulomas need to be examined by high-resolution CT of the chest, enhanced CT of the chest, and percutaneous lung puncture to further identify granulomatous changes caused by tuberculosis, so as not to miss or misdiagnose the manifestations as lung cancer or tumor. Granulomas in the lungs caused by autoimmune diseases, including Wegener’s granulomatosis, systemic lupus erythematosus, rheumatoid arthritis, dermatomyositis, scleroderma and other autoimmune diseases, cause chronic pulmonary fibrotic changes that lead to the formation of granulomas in the lungs, and the diagnosis can be further clarified by high-resolution CT of the chest, or even enhanced CT of the chest and cytology by lung puncture. Most granulomas in the lungs are benign if they are multiple, and if they are solitary, they can be treated by surgical resection.