Imaging findings of pulmonary granulomatosis with polyangiitis (Wegener’s granulomatosis): lesions invading the pulmonary fissure, pleura or diaphragm mimicking malignancy

Abstract

Pulmonary lesion types of GPA have a wide spectrum, potentially mimicking a high number of diseases including malignancy, infection and noninfectious inflammatory diseases. A spiculated lung lesion invading the fissure, pleura or diaphragm is mostly present in malignancy, but it can be also seen in GPA.

A Case of Pulmonary Granulomatosis with Polyangiitis Mimicking Septic Pneumonia Resulting from Middle Ear Infection

“…The pulmonologist decided to administer immunosuppressive agents such as steroids and cyclophosphamide. Four days after initiating the immunosuppressive therapy, her fever, cough, and sputum production improved, as did ferentiating these diseases from pulmonary GPA, but these findings were not observed in our case (1). In our case, we think that central necrosis with low attenuation was accompanied by multiple nodules and wedge-shaped consolidations on CT because…”

“…Although pulmonary GPA is difficult to diagnose by imaging alone, pulmonary cavities and hemorrhage are the most common findings on a chest radiograph and CT scan. Approximately 6-50% of patients with pulmonary GPA have been reported to show cavitation on CT, and the percentage varies widely (1,2).…”

Bilateral Facial Paralysis and Otitis Media as the First Presentations of Wegener’s Granulomatosis: A Case Report

“…7 However, about 15% of subjects are younger than 19 years. 8 Wegener's vasculitis has many different clinical aspects. According to the National Institute of Health (NIH), the most common organs involved at first are the sinuses, lungs, joints (arthralgia and arthritis), ears (otitis media), and kidneys.…”

A Wegener Granulomatosis case with a huge lung lesion mimicking lung cancer

“…Parankimal tutulum akciğer kanserini taklit edip spiküler uzantılarla birlikte fissüre, diaframa ya da plevraya invazyon gösterebilir. Bir çalışmada WG'ye bağlı 126 akciğer nodül ya da kitlesinin 28'inde (%22) spiküler görüntü olduğu bildirilmektedir (9). Aynı çalışmada bu lezyonların büyüklüğünün 30-78 mm (ortalama 26 mm) arasında olduğu da tespit edilmiştir.…”