Granulomatosis with polyangitis - pulmonary cavities

Case contributed by Bruno Di Muzio
Diagnosis almost certain

Presentation

Cough and fever. Recurrence of symptoms three months after her last hospitalization.

Patient Data

Age: 35 years
Gender: Female

Large bilateral pulmonary cavities.

Large bilateral pulmonary cavities, the largest ones containing liquid forming fluid level.

Case Discussion

Granulomatosis with polyangitis (Wegener granulomatosis), is a multi-system systemic necrotizing non-caseating granulomatous vasculitis affecting small to medium-sized arteries, capillaries and veins, and the lungs are the most frequently involved organ, seen in 95% of cases.

The most common radiological presentation is with multiple nodules randomly distributed. In approximately half of cases, some of the nodules demonstrate cavitation, which is best seen with CT.

This case shows multiple cavities and the patient has recurrent pulmonary infections (caused by usual bacteria). On the last hospitalization she was submitted to thoracic drainage and subsequent surgical intervention.

Patient was confirmed to have Granulomatosis with polyangiitis (Wegener granulomatosis).

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