Abstract
Wegener's granulomatosis (WG) is a systemic, granulomatous vasculitis that typically affects the upper airways, lungs, and, in most cases, the kidneys. Lung involvement occurs in 85% of patients. A classic feature of WG is multiple pulmonary nodules, which frequently cavitate. Hilar adenopathy or mediastinal masses are rare. These atypical pulmonary findings should raise suspicion of diseases other than WG and lead to biopsy with cultures, even when the diagnosis of WG appears to be certain. These guidelines proved to be reliable in a patient with WG in whom a hilar mass was associated with tuberculosis.
MeSH terms
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Adult
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Cyclophosphamide / therapeutic use
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Drug Therapy, Combination
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Ethambutol / therapeutic use
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Granulomatosis with Polyangiitis / complications
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Granulomatosis with Polyangiitis / drug therapy
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Granulomatosis with Polyangiitis / pathology*
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Humans
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Immunosuppressive Agents
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Isoniazid / therapeutic use
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Lymph Nodes / diagnostic imaging
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Lymph Nodes / pathology*
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Male
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Prednisone / therapeutic use
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Pyridoxine / therapeutic use
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Radiography, Thoracic
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Sulfamethoxazole / therapeutic use
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Tomography, X-Ray Computed
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Trimethoprim / therapeutic use
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Tuberculosis, Lymph Node / drug therapy
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Tuberculosis, Lymph Node / etiology
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Tuberculosis, Lymph Node / pathology*
Substances
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Immunosuppressive Agents
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Ethambutol
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Cyclophosphamide
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Trimethoprim
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Sulfamethoxazole
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Pyridoxine
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Isoniazid
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Prednisone