Aim: This study aims to investigate the mediastinal granulomatous reactions detected during invasive staging in patients undergoing surgical treatment due to lung cancer in Cappadocia region. Material and Method: 469 patients were included in the study who underwent surgical treatment for lung cancer between 2003 and 2016 in Cappadocia region. Lymph node stations sampled by mediastinoscopy and thoracotomy were evaluated during the invasive staging of the patients. Results: A total of 2637 (mean: 5.6) lymph node stations were sampled from 469 patients with mediastinoscopy and thoracotomy. 21 (4.4%) patients had a granulomatous reaction. The numbers of male and female patients were 17 and 4, respectively. The age of the patients ranged from 52 to 73 years (mean 62.19 +/- 7.5). It was determined that the most common type of cancer in patients with granulomatous reactions were squamous carcinoma (n = 9). Other common cancers were adenocarcinoma (n = 7) and large cell (n = 2) carcinoma. Lymph node metastasis and sarcoidosis reaction association were found in two patients. Discussion: The frequency of granulomatous reactions for lung cancer is 4.4% in Cappadocia region. Although the granulomatous reaction is more frequent in early stage disease, it may be seen in advanced stage patients and may accompany metastatic lymph nodes.