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Case Reports
. 2021 Sep 5;16(11):3445-3450.
doi: 10.1016/j.radcr.2021.08.028. eCollection 2021 Nov.

Granulomatosis with polyangiitis: A case report and brief review of literature

Dhairya A Lakhani  1 , Aneri B Balar  1 , Ayodele Adelanwa  2 , Alexander Gross  2 , Rehab Mohamed  2 , Kelly T Smith  1 , Cathy Kim  1
Affiliations
Case Reports

Granulomatosis with polyangiitis: A case report and brief review of literature

Dhairya A Lakhani et al. Radiol Case Rep. .

Erratum in

Abstract

Granulomatosis with polyangiitis formerly known as Wegener's granulomatosis was first described by German pathologist Friedrich Wegener in 1936. It is a multi-system necrotizing noncaseating granulomatous vasculitis which affects small to medium-sized vessels. It can involve any organ system, most commonly the lungs and kidneys. American College of Rheumatology requires 2 of 4 criteria for diagnosis: Positive biopsy for granulomatous vasculitis, urinary sediment with red blood cells, abnormal chest radiograph and oral/nasal inflammation. Here we present a case of Granulomatosis with polyangiitis with brief review of literature.

Keywords: Granulomatosis with polyangiitis; Vasculitis; Wegener's granulomatosis.

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Figures

Fig 1
Fig. 1
PA (A) and lateral (B) Chest radiograph demonstrates bilateral (right greater than left) multifocal nodular opacity, concerning for round pneumonia.
Fig 2
Fig. 2
CT of the chest axial images, lung (A) and soft tissue (B) reconstruction algorithm, showed numerous (more than 30) bilateral pulmonary nodules/masses, ranging from 20-60 mm in diameter with associated peripheral halo. No pleural effusion or pneumothorax and patent central airway. Findings were favored to represent vasculitis.
Fig 3
Fig. 3
CT of the chest coronal images, showed numerous (more than 30) bilateral pulmonary nodules/masses, ranging from 20-60 mm in diameter with associated peripheral halo sign. No pleural effusion or pneumothorax and patent central airway. Findings were favored to represent vasculitis.
Fig 4
Fig. 4
CT sinus protocol showed complete opacification of left frontal and left sphenoid sinus. Frothy secretions with air-fluid level in the left maxillary sinus. Moderate mucosal thickening of the right maxillary sinus and left greater than right anterior and posterior ethmoid sinuses.
Fig 5
Fig. 5
CT Sinus protocol demonstrates erosion of the anterior cartilaginous portion of the nasal septum
Fig 6
Fig. 6
Normal sonogram of bilateral kidneys.
Fig 7
Fig. 7
Hematoxylin and Eosin 200x (A) and 400x (B) sections of nasal septum showed numerous necrotizing granulomas and foreign-body type giant cells within a background of necroinflammatory debris Necrotizing granulomatous inflammation with foreign-body giant cells.
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