Pseudotumor pulmonar como apresentação inicial de granulomatose de Wegener

Abstract

A granulomatose de Wegener é uma doença inflamatória multissistêmica de etiologia desconhecida, que se caracteriza por vasculite de pequeno e médio calibre. As manifestações clínicas mais comuns envolvem o trato respiratório superior, pulmões e rins e as alterações encontradas nos exames de imagem são geralmente opacidades pulmonares ou nódulos múltiplos, bilaterais e, em 50% dos casos, cavitações. O tratamento é feito com corticoides e imunossupressores. Descreve-se um caso atípico de um homem de 61 anos cuja investigação inicial de um tumor pulmonar unilateral evidenciou, na verdade, Granulomatose de Wegener.

Cavitating lung lesion as a manifestation of inflammatory tumor (pseudotumor) of the lung: A case report and literature review

“…In imaging examinations, WG disease is frequently accompanied by cavitations, frequently associated with pulmonary infiltration or nodules [6,17]. Particular attention should be paid in differential diagnosis of inflammatory pseudotumors from lung cancer, as, according to the relevant literature, the endobronchial inflammatory pseudotumor can mimic a carcinoid tumor [18].…”

“…Particular attention should be paid in differential diagnosis of inflammatory pseudotumors from lung cancer, as, according to the relevant literature, the endobronchial inflammatory pseudotumor can mimic a carcinoid tumor [18]. As CXR films and chest CT cannot both ensure a differential diagnosis between lung inflammatory pseudotumors and other lung diseases of neoplasmatic, infectious, or inflammatory origin, technical means such as tomographic-guided percutaneous biopsy [6] and thoracic surgical intervention [7–9] (including video-assisted thoracic surgery/VATS) were used, followed by histopathologic examination of the specimen received. Similarly, in our described case, the work-up with the aid of FOB, chest CT, abdomen CT, sputum cultures, and cytology was not diagnostic, being in accordance with the majority of cases of patients presenting inflammatory pseudotumors [19].…”

“…The tumor was surgically excised and necrosis was found in the central region [5]. In 2009, a case of a solid lung pseudotumor was reported as an initial presentation of Wegener’s granulomatosis [6]. Histopathological examination established fibrosis and large necrosis accompanied with an inflammatory process [6].…”

“…In 2009, a case of a solid lung pseudotumor was reported as an initial presentation of Wegener’s granulomatosis [6]. Histopathological examination established fibrosis and large necrosis accompanied with an inflammatory process [6]. Cavitary lesions can be found in 50% of all Wegener’s granulomatosis cases [6].…”

“…Histopathological examination established fibrosis and large necrosis accompanied with an inflammatory process [6]. Cavitary lesions can be found in 50% of all Wegener’s granulomatosis cases [6]. Two cases of inflammatory pseudotumors were reported in 2011 [7].…”